SearchMississippi103K00000X

Deidra Fernstrum, BCBA

NPI 1760983100 · on the registry since 2018

Practice

Address
6040 Interstate 55 North Frontage Road
Jackson, MS 39211
Phone
(601) 401-0422

Registry record

Primary taxonomy
103K00000X
103K00000X
Also registered as
106E00000X
106S00000X
Licence states on file
MS, MN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2026-02-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi