Provider Demographics
NPI:1376178525
Name:SWINDELL, JEFFREY NEIL (BCBA)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:NEIL
Last Name:SWINDELL
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 OAK VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-7412
Mailing Address - Country:US
Mailing Address - Phone:615-823-4041
Mailing Address - Fax:
Practice Address - Street 1:1313 OAK VALLEY DR
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-7412
Practice Address - Country:US
Practice Address - Phone:615-823-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
TN629103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst