Provider Demographics
NPI:1154982791
Name:SALEMI, JENNIFER E (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:E
Last Name:SALEMI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:E
Other - Last Name:CASEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:37 SEA BREEZE LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10307-1981
Mailing Address - Country:US
Mailing Address - Phone:908-601-3391
Mailing Address - Fax:
Practice Address - Street 1:37 SEA BREEZE LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10307-1981
Practice Address - Country:US
Practice Address - Phone:908-601-3391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-19-36303103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst