Individual
JENNIFER NICOLE HAMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
14000 NORTHDALE BLVD STE A, ROGERS, MN 55374-4663
(763) 428-2478
Mailing address
18172 MACON ST NW, ELK RIVER, MN 55330-5615
(906) 364-3832
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42998
—
Other
Enumeration date
10/11/2019
Last updated
08/03/2023
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