Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. JENNIFER MICHELLE DETHERAGE, MS, BCBA
ActiveMS. JENNIFER MICHELLE DETHERAGE, MS, BCBA is a Behavior Analyst healthcare provider located in FAYETTEVILLE, Georgia. NPI 1508325135 is currently active in the NPPES registry. Verify at CMS.
Behavior Analyst · FAYETTEVILLE, GA
Registration Details
- NPI Number
- 1508325135
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 13, 2019 (7.6295053639962 yrs)
- Last Updated
- Aug 11, 2025
- License
-
1-20-44609 (GA)
Practice Information
- Address
-
126 PAVILION PKWYFAYETTEVILLE, GA, 302144056Browse GA providers · Browse ZIP 30214
- Phone
- 7709548988
- Fax
- 3175208200
- Primary Specialty
-
Behavior Analyst
103K00000X
Other Behavior Analyst Providers in FAYETTEVILLE, GA
| Name | Credential | NPI |
|---|---|---|
| MR. JAY ANTHONY RAMOS SR. | — | 1518298496 |
| MR. JAY ANTHONY RAMOS II | — | 1982935862 |
| ANNE KENNEDY | M.A, BCBA | 1669774063 |
| LYSA MARI HARAWAY | BCBA | 1164795738 |
| ELIZABETH K FOSTER | M.ED, BCBA | 1447507652 |
| MS. GINA CROSS | BCBA, MS | 1477936185 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.