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General NPI Number Information
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NPI Number | 1164104378
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Entity Type | Individual
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Provider Name | JENNA MARIE ENGEL
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Gender | Female
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Dates
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Enumeration Date | 08/07/2023
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Last Update Date | 07/12/2024
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Provider Practice Location Address
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Address Line | 156 RT. 15 NORTH
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City | LAFAYETTE
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State | NJ
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Zip | 07848
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Country | US
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Telephone | 973-862-6377
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Fax | 973-862-6379
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Provider Business Mailing Address
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Address Line | 156 NJ-15 NORTH
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City | LAFAYETTE
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State | NJ
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Zip | 07848
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Country | US
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Telephone | 973-862-6377
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-23-65914
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License Number State | NJ
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