Provider Demographics
NPI:1285044974
Name:HEIDT, JENNIFER ISLER (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ISLER
Last Name:HEIDT
Suffix:
Gender:F
Credentials:MS, BCBA
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4092 MEMORIAL PKWY SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-4365
Mailing Address - Country:US
Mailing Address - Phone:256-882-2457
Mailing Address - Fax:256-882-2459
Practice Address - Street 1:4092 MEMORIAL PKWY SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-4365
Practice Address - Country:US
Practice Address - Phone:256-882-2457
Practice Address - Fax:256-882-2459
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst