Provider Demographics
NPI:1134415797
Name:SIGNS, JEANINE PATRICE (BCBA)
Entity type:Individual
Prefix:MS
First Name:JEANINE
Middle Name:PATRICE
Last Name:SIGNS
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 1:10385 OVIATT LN
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1472
Mailing Address - Country:US
Mailing Address - Phone:330-603-8534
Mailing Address - Fax:
Practice Address - Street 1:10385 OVIATT LN
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1472
Practice Address - Country:US
Practice Address - Phone:330-603-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-18-29533103K00000X
OH0-11-4112103K00000X
OH1-18-29533103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty