Provider Demographics
NPI:1104599851
Name:IHM, JENNIFER K (M ED , BCBA, LBS)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:IHM
Suffix:
Gender:F
Credentials:M ED , BCBA, LBS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KRISTEN
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:406 JEFFERSON CT APT 103
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18067-8225
Mailing Address - Country:US
Mailing Address - Phone:610-360-9593
Mailing Address - Fax:
Practice Address - Street 1:1405 N CEDAR CREST BLVD STE 109
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2308
Practice Address - Country:US
Practice Address - Phone:856-346-0005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1-21-47848103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst