Provider Demographics
NPI:1720347180
Name:RYMANOWSKI, JENNIFER L (PHD, BCBA-D, LBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:RYMANOWSKI
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:RHEINHEIMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:49 HYACINTH LN
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-9219
Mailing Address - Country:US
Mailing Address - Phone:585-507-1357
Mailing Address - Fax:
Practice Address - Street 1:1000 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3042
Practice Address - Country:US
Practice Address - Phone:585-271-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X
NY000079-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool