Provider Demographics
NPI:1730860776
Name:CHEVEZ, JENNIFER YESSENIA (MA,BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:YESSENIA
Last Name:CHEVEZ
Suffix:
Gender:F
Credentials:MA,BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21630 MERCHANTS WAY BLDG B
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2514
Mailing Address - Country:US
Mailing Address - Phone:832-230-1939
Mailing Address - Fax:
Practice Address - Street 1:21630 MERCHANTS WAY BLDG B
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-2514
Practice Address - Country:US
Practice Address - Phone:832-230-1939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6079103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst