Provider Demographics
NPI:1902076912
Name:BORR, JENNIFER (BCBA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:BORR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 SW 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-3710
Mailing Address - Country:US
Mailing Address - Phone:786-355-8271
Mailing Address - Fax:
Practice Address - Street 1:3911 SW 67TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155
Practice Address - Country:US
Practice Address - Phone:306-854-2462
Practice Address - Fax:786-542-9754
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0-06-2137OtherBACB