Provider Demographics
NPI:1962705426
Name:ARMITAGE, JENNIFER L (MS BCBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:ARMITAGE
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 1:7450 BLUE JACKET PL E
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-9204
Mailing Address - Country:US
Mailing Address - Phone:321-662-2230
Mailing Address - Fax:
Practice Address - Street 1:7450 BLUE JACKET PL E
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-9204
Practice Address - Country:US
Practice Address - Phone:321-662-2230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-09-5807103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst