Provider Demographics
NPI:1245884741
Name:CAMMARATA, JENNIFER COOKE (BCBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:COOKE
Last Name:CAMMARATA
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4528 PLANK RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-0141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10692 LEONARD CORDOVA RD
Practice Address - Street 2:
Practice Address - City:RENICK
Practice Address - State:WV
Practice Address - Zip Code:24966-7256
Practice Address - Country:US
Practice Address - Phone:330-565-3386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-01
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001521103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst