Provider Demographics
NPI:1720697154
Name:CHUMITA, JODI LYNNE (BA)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:LYNNE
Last Name:CHUMITA
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:LYNNE
Other - Last Name:SARVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3720 DRESSLER RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-2700
Mailing Address - Country:US
Mailing Address - Phone:330-309-3133
Mailing Address - Fax:330-319-8460
Practice Address - Street 1:3720 DRESSLER RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-2700
Practice Address - Country:US
Practice Address - Phone:330-309-3133
Practice Address - Fax:330-319-8460
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRBT-20-113331106S00000X
OH0-24-15432106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician