Provider Demographics
NPI:1801462437
Name:HUFFMAN, JODI ELIZABETH (BCBA)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:ELIZABETH
Last Name:HUFFMAN
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 1:1379 BARBER DR
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81623-1886
Mailing Address - Country:US
Mailing Address - Phone:410-790-1076
Mailing Address - Fax:
Practice Address - Street 1:1379 BARBER DR
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:CO
Practice Address - Zip Code:81623-1886
Practice Address - Country:US
Practice Address - Phone:410-790-1076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-03
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-22-62519103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst