Provider Demographics
NPI:1740681378
Name:AMOROSO, JENNIFER (BCBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:AMOROSO
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 1:2 PIN OAK LN
Mailing Address - Street 2:SUITE 250
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1632
Mailing Address - Country:US
Mailing Address - Phone:856-669-0211
Mailing Address - Fax:
Practice Address - Street 1:2 PIN OAK LN
Practice Address - Street 2:SUITE 250
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1632
Practice Address - Country:US
Practice Address - Phone:856-669-0211
Practice Address - Fax:856-424-7660
Is Sole Proprietor?:No
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-10-6858103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst