Provider Demographics
NPI:1164710042
Name:IROFF, JENNIFER ERIN (MS BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ERIN
Last Name:IROFF
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4492 ACWORTH INDUSTRIAL DR NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30101-5659
Mailing Address - Country:US
Mailing Address - Phone:404-232-9111
Mailing Address - Fax:
Practice Address - Street 1:335 PARKWAY 575
Practice Address - Street 2:SUITE 220
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-6433
Practice Address - Country:US
Practice Address - Phone:770-591-9552
Practice Address - Fax:180-021-8824
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
1-11-8747103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-11-8747OtherBEHAVIOR ANALYSIS CERTIFICATION BOARD