Provider Demographics
NPI:1326357740
Name:MALONEY, JENNIFER CAITLIN (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:CAITLIN
Last Name:MALONEY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01038-9721
Mailing Address - Country:US
Mailing Address - Phone:413-335-6334
Mailing Address - Fax:
Practice Address - Street 1:25 SOUTH ST
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:MA
Practice Address - Zip Code:01038-9721
Practice Address - Country:US
Practice Address - Phone:413-335-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1-08-4586103K00000X
CT1-08-4586103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst