MEDICARE: MR. JONATHAN HEATH SHERRER BCBA

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
1	103K00000X	Behavior Analyst	1-06-2956	AL

General Provider Information

NPI Number	:	1568808319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JONATHAN HEATH SHERRER BCBA

Provider Business Mailing Address
First Line	:	6650 COTTAGE HILL RD APT 1417
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-3799
Country	:	US
Telephone Number	:	334-663-3503
Fax Number	:

Provider Business Practice Location Address
First Line	:	6650 COTTAGE HILL RD APT 1417
Second Line	:
City	:	MOBILE
State	:	AL
Zip	:	36695-3799
Country	:	US
Telephone Number	:	334-663-3503
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2013
Last Update Date	:	05/20/2013

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