Provider Demographics
NPI:1861023954
Name:WILLIAMS, JENNIFER HANALEE (BCBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HANALEE
Last Name:WILLIAMS
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 1:4530 E RAY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-6095
Mailing Address - Country:US
Mailing Address - Phone:480-801-1130
Mailing Address - Fax:
Practice Address - Street 1:4530 E RAY RD STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-6095
Practice Address - Country:US
Practice Address - Phone:480-801-1130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2024-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst