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

Primary practice address
458 Coulee Trl Hudson WI 54016-8156
Fax:
Website:

Health care specialties

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972990034 NPPES
Other 1-15-17917 BCBA CERTIFICATION

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