Provider Demographics
NPI:1700040284
Name:MAYER, JULIET J (MS, BCBA)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:J
Last Name:MAYER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:JULIET
Other - Middle Name:L
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS BCBA
Mailing Address - Street 1:8020 CANONBURY DR
Mailing Address - Street 2:
Mailing Address - City:NOLENSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37135-4027
Mailing Address - Country:US
Mailing Address - Phone:615-481-0801
Mailing Address - Fax:
Practice Address - Street 1:8020 CANONBURY DR
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-4027
Practice Address - Country:US
Practice Address - Phone:615-481-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-15
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-06-2943174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist