Provider Demographics
NPI:1033798608
Name:KAISER, JESSICA (COMS, VRT, BSW)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:
Last Name:KAISER
Suffix:
Gender:F
Credentials:COMS, VRT, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2380
Mailing Address - Country:US
Mailing Address - Phone:716-888-4581
Mailing Address - Fax:716-888-4581
Practice Address - Street 1:1170 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2380
Practice Address - Country:US
Practice Address - Phone:716-888-4581
Practice Address - Fax:716-888-4581
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23011225CX0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CX0006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorOrientation and Mobility Training Provider