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NPI Code Detail

MEDICARE: MRS. JENNIFER WEST DANTZLER BCBA

MEDICARE:  MRS. JENNIFER WEST DANTZLER  BCBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1020763TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11020763OTHERBCBA

General Provider Information

NPI Number : 1013144153
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER WEST DANTZLER BCBA
Provider Business Mailing Address
First Line : 14411 BRIGHTON TRACE LN
Second Line :
City : HOUSTON
State : TX
Zip : 77044-4436
Country : US
Telephone Number : 281-852-0501
Fax Number :
Provider Business Practice Location Address
First Line : 5364 FM 1960 RD E
Second Line :
City : HUMBLE
State : TX
Zip : 77346-2502
Country : US
Telephone Number : 281-852-0501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2009
Last Update Date : 06/16/2009

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Directions to “ MRS. JENNIFER WEST DANTZLER BCBA” Practice Location

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