Provider Demographics
NPI:1164839106
Name:ABROM, JENNIFER SIMPKINS (BCBA)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:SIMPKINS
Last Name:ABROM
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 1:27604 CASHFORD CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6952
Mailing Address - Country:US
Mailing Address - Phone:813-345-8584
Mailing Address - Fax:813-345-8584
Practice Address - Street 1:2121 NEW MARKET PKWY SE STE 130
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-9309
Practice Address - Country:US
Practice Address - Phone:678-940-1911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-17-27904OtherBCBA CERTIFICATE