Individual
JENNIFER NATASHA OMELIANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2335 PEAK RD, LYNDONVILLE, VT 05851-9546
(203) 233-5497
Mailing address
11109 HELMS DEEP DR, AUSTIN, TX 78754-4062
(802) 535-2833
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66739
TX
106E00000X
Assistant Behavior Analyst
0-21-11688
TX
Other
Enumeration date
01/27/2021
Last updated
12/18/2024
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