Provider Demographics
NPI:1609498518
Name:NOVAK, JENNIFER DENISE I (BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DENISE
Last Name:NOVAK
Suffix:I
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 1:1 BELL CT
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1331
Mailing Address - Country:US
Mailing Address - Phone:732-754-0114
Mailing Address - Fax:
Practice Address - Street 1:1 BELL CT
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1331
Practice Address - Country:US
Practice Address - Phone:732-754-0114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst