Most Relevant Information
Provider Data
| NPI Number: | 1003673237 |
| Provider Name: | JENNIFER ROSE |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/04/2024 |
| Last Updated: | 03/04/2024 |
Provider Practice Location
1500 S HAVEN AVE STE 250
ONTARIO
CA
917612973
Practice Location Phone/Fax
| Phone: | 9097495204 |
| Fax: |
Provider Mailing Location
2346 W COLLEGE AVE
SAN BERNARDINO
CA
924072494
Provider Mailing Phone/Fax
| Phone: | 9098714144 |
| Fax: |