Provider Demographics
NPI:1134566896
Name:MAHARREY, JODIE (BCBA)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:MAHARREY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:
Other - Last Name:NEWSOME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3981 KYLE LN
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-5633
Mailing Address - Country:US
Mailing Address - Phone:205-610-9616
Mailing Address - Fax:
Practice Address - Street 1:3981 KYLE LN
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-5633
Practice Address - Country:US
Practice Address - Phone:205-610-9616
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst