Healthcare Provider Details

I. General information

NPI: 1871945519
Provider Name (Legal Business Name): JENNIFER HUFFMAN BCBA/LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2016
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2314 S VAL VISTA DR
GILBERT AZ
85295-5570
US

IV. Provider business mailing address

34556 N APPALOOSA WAY
SAN TAN VALLEY AZ
85142-4431
US

V. Phone/Fax

Practice location:
  • Phone: 623-263-3966
  • Fax:
Mailing address:
  • Phone: 480-793-2622
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: