Provider Demographics
NPI:1245795038
Name:WOODS, JENNIFER (BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:WOODS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:344 CREAMERY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH RYEGATE
Mailing Address - State:VT
Mailing Address - Zip Code:05069-8903
Mailing Address - Country:US
Mailing Address - Phone:802-733-5118
Mailing Address - Fax:
Practice Address - Street 1:344 CREAMERY RD
Practice Address - Street 2:
Practice Address - City:SOUTH RYEGATE
Practice Address - State:VT
Practice Address - Zip Code:05069-8903
Practice Address - Country:US
Practice Address - Phone:802-733-5118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst