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General NPI Number Information
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NPI Number | 1245836410
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Entity Type | Individual
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Provider Name | JENNIFER HELENA ONUSCHAK
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Gender | Female
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Dates
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Enumeration Date | 12/11/2020
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 290 HIGHWAY 314
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7813
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Country | US
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Telephone | 770-249-5322
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Fax |
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Provider Business Mailing Address
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Address Line | 3800 TROTTERS RUN
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-7602
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Country | US
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Telephone | 484-934-7207
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-79796
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License Number State |
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