Provider Demographics
NPI:1023682390
Name:STANSEL, JENNIFER LINDSEY (BCBA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LINDSEY
Last Name:STANSEL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2018 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-3270
Mailing Address - Country:US
Mailing Address - Phone:907-205-7042
Mailing Address - Fax:
Practice Address - Street 1:2018 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-3270
Practice Address - Country:US
Practice Address - Phone:907-205-7042
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-19
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK169813103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst