Provider Demographics
NPI:1851155337
Name:HUFF, JENNIFER L (BCBA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:HUFF
Suffix:
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 1:396 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3006
Mailing Address - Country:US
Mailing Address - Phone:207-989-2946
Mailing Address - Fax:
Practice Address - Street 1:396 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3006
Practice Address - Country:US
Practice Address - Phone:207-573-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1-23-70269103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst