Provider Demographics
NPI:1174887533
Name:BONOW, JENNIFER A C (PHD, BCBA-D, LBA)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:A C
Last Name:BONOW
Suffix:
Gender:F
Credentials:PHD, BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2435 PYRAMID WAY STE B
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-1865
Mailing Address - Country:US
Mailing Address - Phone:775-657-8309
Mailing Address - Fax:775-657-8359
Practice Address - Street 1:2435 PYRAMID WAY STE B
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-1865
Practice Address - Country:US
Practice Address - Phone:775-657-8309
Practice Address - Fax:775-657-8359
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-30
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVLBA0006103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst