Individual
JENNIFER BACIGALUPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LBA BCBA
Contact information
Practice address
5025 E WASHINGTON ST STE 212, PHOENIX, AZ 85034-7439
(602) 773-5773
Mailing address
200 E FILLMORE ST APT 326, PHOENIX, AZ 85004-2118
(347) 723-5366
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
886516
—
AZ
05
—
963969
—
AZ
Enumeration date
11/09/2021
Last updated
11/09/2021
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