Provider Demographics
NPI:1538470901
Name:STEPHENS, JENNIFER L (BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:STEPHENS
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 1:9 COLLEGE ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SOUTH HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01075-1421
Mailing Address - Country:US
Mailing Address - Phone:413-534-7400
Mailing Address - Fax:413-534-7483
Practice Address - Street 1:9 COLLEGE ST
Practice Address - Street 2:SUITE 6
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-1421
Practice Address - Country:US
Practice Address - Phone:413-534-7400
Practice Address - Fax:413-534-7483
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst