JENNIFER MICHELLE DETHERAGE

FAYETTEVILLE, GA
NPI1508325135
Former NameJENNIFER MICHELLE WOMACK
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy103K00000X Behavior Analyst
(Licence: GA  1-20-44609)
Enumeration Date2019-03-13
Last Update Date2025-08-11
Business Address
Ms. JENNIFER MICHELLE DETHERAGE MS, BCBA
126 PAVILION PKWY
FAYETTEVILLE, GA 30214-4056
Phone number: 770-954-8988
Mailing Address
Ms. JENNIFER MICHELLE DETHERAGE MS, BCBA
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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