Individual
JENNA MICHELLE DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
505 OBERLIN RD, SUTIE 230, RALEIGH, NC 27605-1327
(919) 743-0204
Mailing address
762 WOBURN ABBEY DR, FORT MILL, SC 29715-6930
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-33534
—
Other
Enumeration date
03/30/2017
Last updated
09/04/2025
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