Provider Demographics
NPI:1679756290
Name:REDDING, JONATHAN CLARK (BCBA)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:CLARK
Last Name:REDDING
Suffix:
Gender:M
Credentials:BCBA
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:CLARK
Other - Last Name:REDDING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:373 S WILLOW ST STE 266
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-5751
Mailing Address - Country:US
Mailing Address - Phone:877-315-8080
Mailing Address - Fax:877-345-4009
Practice Address - Street 1:3152 ANCHORWAY CT
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-7549
Practice Address - Country:US
Practice Address - Phone:877-315-8080
Practice Address - Fax:877-345-4009
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst