Provider Demographics
NPI:1891255634
Name:LACROIX, JENNILEE (MS, BCBA)
Entity type:Individual
Prefix:MS
First Name:JENNILEE
Middle Name:
Last Name:LACROIX
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 HURRICANE RD
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431-2163
Mailing Address - Country:US
Mailing Address - Phone:603-762-0061
Mailing Address - Fax:
Practice Address - Street 1:710 HURRICANE RD
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-2163
Practice Address - Country:US
Practice Address - Phone:603-762-0061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-20
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst