Waldera, Jeryn Lee
Waldera, Jeryn Lee is an sole proprietor health care provider with primary practice located at 458 Coulee Trl , Hudson WI 54016-8156. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Waldera, Jeryn Lee can be contacted via phone (715) 410-1182.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X |
Profile Details
| NPI number | 1972990034 |
|---|---|
| LBN Legal business name | Waldera, Jeryn Lee |
| Credentials | BCBA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 16th, 2015 |
| Last updated | Apr 16th, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972990034 | NPPES |
| Other | 1-15-17917 | BCBA CERTIFICATION |
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