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General NPI Number Information
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NPI Number | 1679385769
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Entity Type | Individual
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Provider Name | JENNIFER EFFENBERGER DONALD BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 106 CIRCLE WAY ST STE C
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City | LAKE JACKSON
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State | TX
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Zip | 77566-5270
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Country | US
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Telephone | 281-310-0632
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Fax |
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Provider Business Mailing Address
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Address Line | 34547 FM 1301 RD
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City | WEST COLUMBIA
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State | TX
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Zip | 77486-9810
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Country | US
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Telephone | 361-944-3195
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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 |
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License Number State |
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