Healthcare Provider Details

I. General information

NPI: 1568808319
Provider Name (Legal Business Name): JONATHAN HEATH SHERRER BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10063 ROCKWELL SCHOOL DR STE D
SPANISH FORT AL
36527-8511
US

IV. Provider business mailing address

10063 ROCKWELL SCHOOL DR STE D
SPANISH FORT AL
36527-8511
US

V. Phone/Fax

Practice location:
  • Phone: 251-210-8200
  • Fax: 251-249-9942
Mailing address:
  • Phone: 251-210-8200
  • Fax: 251-249-9942

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-06-2956
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: