Healthcare Provider Details

I. General information

NPI: 1922760909
Provider Name (Legal Business Name): JENNIFER HERNANDEZ BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2021
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 SATELLITE BLVD
DULUTH GA
30097-5256
US

IV. Provider business mailing address

1845 SATELLITE BLVD
DULUTH GA
30097-5256
US

V. Phone/Fax

Practice location:
  • Phone: 404-295-7941
  • Fax:
Mailing address:
  • Phone: 404-295-7941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: