Individual provider · Type 1 NPI
Deidra Marie Fernstrum, BCBA
Behavior Analyst · Jackson, MS
Practice location
6040 Interstate 55 North Frontage Road
Jackson, MS 39211
Mailing address
1315 Robert Dr
Jackson, MS 39211-6337
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst Primary | 103K00000X | 200041 (MS) |
| Assistant Behavior Analyst | 106E00000X | 201008A (MN) |
| Behavior Technician | 106S00000X | None listed |
Behavior Analyst: A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis…
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About NPI 1760983100
Deidra Marie Fernstrum, BCBA's National Provider Identifier is 1760983100, issued on Feb 21, 2018. The primary taxonomy on file is Behavior Analyst (103K00000X), and the practice location is in Jackson, MS. The record was last updated on Feb 17, 2026.