Provider Demographics
NPI:1568836476
Name:JUMPER, ELIAS (LBS, MS)
Entity Type:Individual
Prefix:
First Name:ELIAS
Middle Name:
Last Name:JUMPER
Suffix:
Gender:M
Credentials:LBS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 STATE AVE
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-4432
Mailing Address - Country:US
Mailing Address - Phone:717-243-6033
Mailing Address - Fax:717-243-0776
Practice Address - Street 1:33 STATE AVE
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4432
Practice Address - Country:US
Practice Address - Phone:717-243-6033
Practice Address - Fax:717-243-0776
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH001797103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst