Healthcare Provider Details

I. General information

NPI: 1518309335
Provider Name (Legal Business Name): JENNIFER M FELBER PH.D., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N FRENCH RD
AMHERST NY
14228-2008
US

IV. Provider business mailing address

415 N FRENCH RD
AMHERST NY
14228-2008
US

V. Phone/Fax

Practice location:
  • Phone: 716-629-3400
  • Fax: 716-799-8529
Mailing address:
  • Phone: 716-629-3400
  • Fax: 716-799-8529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberP95228
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number9795
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number000432
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: