Basic Information
| Provider Information | |||||||||
| NPI: | 1154926624 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEAL | ||||||||
| FirstName: | JENNIFER | ||||||||
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| Credential: | BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5420 W 151ST ST | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662248713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132195696 | ||||||||
| FaxNumber: | 9133384817 | ||||||||
| Practice Location | |||||||||
| Address1: | 5420 W 151ST ST | ||||||||
| Address2: | |||||||||
| City: | LEAWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662248713 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9132195696 | ||||||||
| FaxNumber: | 9133384817 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2020 | ||||||||
| LastUpdateDate: | 08/09/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/09/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106E00000X | 2022007550 | MO | N | 106S00000X | N | 103K00000X | 2022030957 | MO | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.