Healthcare Provider Details

I. General information

NPI: 1457632986
Provider Name (Legal Business Name): JODI E NUERNBERGER PH.D., BCBA-D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2011
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 COLE TER
NEW ROCHELLE NY
10801-1504
US

IV. Provider business mailing address

N8964 STATE HIGHWAY 102
RIB LAKE WI
54470-9415
US

V. Phone/Fax

Practice location:
  • Phone: 210-606-8676
  • Fax:
Mailing address:
  • Phone: 715-225-3967
  • 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: