Healthcare Provider Details

I. General information

NPI: 1265888465
Provider Name (Legal Business Name): JENNIFER LOEHDING BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2016
Last Update Date: 05/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11181 W CRESTLINE DR
LITTLETON CO
80127-1642
US

IV. Provider business mailing address

11181 W CRESTLINE DR
LITTLETON CO
80127-1642
US

V. Phone/Fax

Practice location:
  • Phone: 303-519-3053
  • Fax:
Mailing address:
  • Phone: 303-519-3053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number1-15-20537
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: