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NPI Code Detail

MEDICARE: JENNIFER AHLSWEDE BCBA, MS

MEDICARE:   JENNIFER  AHLSWEDE  BCBA, MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-25-83582GA

General Provider Information

NPI Number : 1568053585
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER AHLSWEDE BCBA, MS
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 4150 DEPUTY BILL CANTRELL MEMORIAL RD
Second Line : SUITE T200
City : CUMMING
State : GA
Zip : 30040-3004
Country : US
Telephone Number : 470-839-3041
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2021
Last Update Date : 08/21/2025

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