Provider Demographics
NPI:1255783676
Name:ADAMS, JENNIFER ANN (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:510 PHILADELPHIA PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19809-2100
Mailing Address - Country:US
Mailing Address - Phone:302-762-2636
Mailing Address - Fax:302-762-2608
Practice Address - Street 1:210 BELLEFONTE AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19809-2502
Practice Address - Country:US
Practice Address - Phone:302-762-2636
Practice Address - Fax:302-762-2608
Is Sole Proprietor?:No
Enumeration Date:2016-07-09
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1-16-22442103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst