Provider Demographics
NPI:1932712684
Name:VAN EPS, JENNA (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:VAN EPS
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:BARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 READ RD
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 READ RD
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1018
Practice Address - Country:US
Practice Address - Phone:862-432-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst