Provider Demographics
NPI:1134415102
Name:JENKINS, JONAS A (MA, BCBA)
Entity type:Individual
Prefix:
First Name:JONAS
Middle Name:A
Last Name:JENKINS
Suffix:
Gender:M
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 BROOKDALE DR
Mailing Address - Street 2:
Mailing Address - City:EAST POINT
Mailing Address - State:GA
Mailing Address - Zip Code:30344-2811
Mailing Address - Country:US
Mailing Address - Phone:404-202-8492
Mailing Address - Fax:
Practice Address - Street 1:1030 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-2811
Practice Address - Country:US
Practice Address - Phone:404-202-8492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-21-53844103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst