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General NPI Number Information
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NPI Number | 1700456472
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Entity Type | Individual
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Provider Name | JENNIFER DEOLIVEIRA
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Gender | Female
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 418-424 CENTRAL AVE, UNIT 2
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City | WESTFIELD
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State | NJ
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Zip | 07090
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Country | US
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Telephone | 888-261-1110
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Fax |
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Provider Business Mailing Address
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Address Line | 55 SCHANCK RD STE A-8
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City | FREEHOLD
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State | NJ
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Zip | 07728-2963
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Country | US
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Telephone | 908-917-2552
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Fax | 908-271-7110
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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 | 1-21-49222
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License Number State | NJ
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