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NPI Code Detail

MEDICARE: DR. JENNIFER A C BONOW PHD, BCBA-D, LBA

MEDICARE:  DR. JENNIFER A C BONOW  PHD, BCBA-D, LBA
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 AnalystLBA0006NV

General Provider Information

NPI Number : 1174887533
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER A C BONOW PHD, BCBA-D, LBA
Provider Business Mailing Address
First Line : 2435 PYRAMID WAY STE B
Second Line :
City : SPARKS
State : NV
Zip : 89431-1865
Country : US
Telephone Number : 775-657-8309
Fax Number : 775-657-8359
Provider Business Practice Location Address
First Line : 2435 PYRAMID WAY STE B
Second Line :
City : SPARKS
State : NV
Zip : 89431-1865
Country : US
Telephone Number : 775-657-8309
Fax Number : 775-657-8359
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2012
Last Update Date : 07/29/2024

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Directions to “ DR. JENNIFER A C BONOW PHD, BCBA-D, LBA” Practice Location

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