Jennifer Dominick, MPA, BSL
Individual provider Active NPI Behavior Analyst · Exeter, PA
NPI 1831697382 · NPPES record last updated Jan 30, 2018
Key facts
- NPI
- 1831697382
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- BH001760 (PA)
- Practice address
- 1122 Wyoming Ave
Exeter, PA 18643-1918 - Phone
- (570) 655-1667
- NPI assigned
- Jan 30, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Science - Law
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BH001760 | PA | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abs Group Inc. | Behavior Analyst | Current | Accepting new patients |
Locations
1122 Wyoming Ave
Exeter, PA 18643
Phone (570) 655-1667
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | BH001760 | PA | Yes |
Addresses
Primary practice location
1122 Wyoming Ave
Exeter, PA 18643-1918
Mailing address
207 E 8TH St
Wyoming, PA 18644-2040
Other providers in Exeter, PA
- Lori Chromey
- Ashley Ciavarella
- Community Living Services
- Michael William Corbett
- Ryan Shane Dambach
- Esposito'S Inc.
- Christopher Michael Evans
- Valerie A Evans
- Exeter Community Ambulance Assoc
- Sarah Elizabeth Fife
All providers in Exeter, PA · Behavior Analyst in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.