Provider Demographics
NPI:1417124520
Name:JOSENDALE, JULIANNE RENEE (MS, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:RENEE
Last Name:JOSENDALE
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 1:26180 W 77TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66227-3013
Mailing Address - Country:US
Mailing Address - Phone:214-208-4128
Mailing Address - Fax:913-586-4989
Practice Address - Street 1:26180 W 77TH ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66227-3013
Practice Address - Country:US
Practice Address - Phone:214-208-4128
Practice Address - Fax:913-586-4989
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-02-0986103K00000X, 222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist