Provider Demographics
NPI:1821724485
Name:SADUDDIN, JENNIFER LYNN (BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:SADUDDIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:LYNN
Other - Last Name:DONOHOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31557 SCHOOLCRAFT RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-1848
Mailing Address - Country:US
Mailing Address - Phone:734-530-3907
Mailing Address - Fax:
Practice Address - Street 1:31557 SCHOOLCRAFT RD STE 200
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1848
Practice Address - Country:US
Practice Address - Phone:734-530-3907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst