Provider Demographics
NPI:1871945519
Name:HUFFMAN, JENNIFER (BCBA/LBA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:HUFFMAN
Suffix:
Gender:F
Credentials:BCBA/LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34556 N APPALOOSA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-4431
Mailing Address - Country:US
Mailing Address - Phone:480-793-2622
Mailing Address - Fax:
Practice Address - Street 1:7165 E UNIVERSITY DR STE 149
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-6412
Practice Address - Country:US
Practice Address - Phone:816-728-8885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst