Provider Demographics
NPI:1396020905
Name:SALVINA, JENNIFER MARIE (BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:SALVINA
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 1:2010 DOWNY DR
Mailing Address - Street 2:#58
Mailing Address - City:HEBRON
Mailing Address - State:KY
Mailing Address - Zip Code:41048-7140
Mailing Address - Country:US
Mailing Address - Phone:419-203-0318
Mailing Address - Fax:
Practice Address - Street 1:2010 DOWNY DR
Practice Address - Street 2:#58
Practice Address - City:HEBRON
Practice Address - State:KY
Practice Address - Zip Code:41048-7140
Practice Address - Country:US
Practice Address - Phone:419-203-0318
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-14
Last Update Date:2011-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-11-8968103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst