Healthcare Provider Details

I. General information

NPI: 1720347180
Provider Name (Legal Business Name): JENNIFER L RYMANOWSKI PHD, BCBA-D, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER RHEINHEIMER

II. Dates (important events)

Enumeration Date: 05/04/2012
Last Update Date: 02/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 ELMWOOD AVE
ROCHESTER NY
14620-3042
US

IV. Provider business mailing address

49 HYACINTH LN
FAIRPORT NY
14450-9219
US

V. Phone/Fax

Practice location:
  • Phone: 585-271-0680
  • Fax:
Mailing address:
  • Phone: 585-507-1357
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number000079-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: