Healthcare Provider Details

I. General information

NPI: 1821468828
Provider Name (Legal Business Name): JENNIFER CUMMINGS M.A., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 HILLRISE CIR
LAS CRUCES NM
88011-4741
US

IV. Provider business mailing address

1517 BLAKE ST STE 250
DENVER CO
80202-5943
US

V. Phone/Fax

Practice location:
  • Phone: 575-288-1881
  • Fax: 575-288-1889
Mailing address:
  • Phone: 575-288-1881
  • Fax: 575-288-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number11518451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: