Provider Demographics
NPI:1790460947
Name:WELTNER, JENNIFER KATHRYN (BCBA, LBA-NY)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:KATHRYN
Last Name:WELTNER
Suffix:
Gender:F
Credentials:BCBA, LBA-NY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 MANHATTAN AVE APT 2L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-2023
Mailing Address - Country:US
Mailing Address - Phone:973-647-8435
Mailing Address - Fax:
Practice Address - Street 1:85 DELANCEY ST FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-3182
Practice Address - Country:US
Practice Address - Phone:917-680-5805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002661103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst