Jenna Vanallen

Individual provider Active NPI Behavior Analyst · Palmyra, WI

NPI 1235504689 · NPPES record last updated Dec 10, 2015

Key facts

NPI
1235504689
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
119 Mill Rd
Palmyra, WI 53156-9310
Phone
(262) 370-5527
Fax
(262) 495-8689
NPI assigned
Dec 10, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

119 Mill Rd
Palmyra, WI 53156-9310

Mailing address

PO Box 192
Palmyra, WI 53156-0192
Phone (262) 370-5527

Other providers in Palmyra, WI

All providers in Palmyra, WI · Behavior Analyst in Wisconsin

Sources for this page

Verify at the official NPI Registry.