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General NPI Number Information
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NPI Number | 1669134888
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Entity Type | Individual
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Provider Name | JENNIFER LAUREN CHAMPION-SPERKOSKI
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Gender | Female
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Dates
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Enumeration Date | 10/06/2021
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Last Update Date | 10/06/2021
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Provider Practice Location Address
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Address Line | 7717 E SANDALWOOD DR
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City | SCOTTSDALE
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State | AZ
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Zip | 85250-7732
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Country | US
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Telephone | 805-341-8459
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Fax |
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Provider Business Mailing Address
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Address Line | 20695 N 94TH DR
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City | PEORIA
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State | AZ
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Zip | 85382-5332
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Country | US
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Telephone |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State |
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