Provider Demographics
NPI:1215343272
Name:PIONKOWSKI, JEFFREY (BCBA , MA)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:PIONKOWSKI
Suffix:
Gender:M
Credentials:BCBA , MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8782 HAWTHORNE DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55347-1714
Mailing Address - Country:US
Mailing Address - Phone:612-382-2102
Mailing Address - Fax:
Practice Address - Street 1:8782 HAWTHORNE DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55347-1714
Practice Address - Country:US
Practice Address - Phone:612-382-2102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN018-MUL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst