Provider Demographics
NPI:1164180360
Name:CREAL, JENESSA (MS ED, BCBA, LBS)
Entity Type:Individual
Prefix:
First Name:JENESSA
Middle Name:
Last Name:CREAL
Suffix:
Gender:F
Credentials:MS ED, BCBA, LBS
Other - Prefix:
Other - First Name:JENESSA
Other - Middle Name:
Other - Last Name:HOSLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED, BCBA, LBS
Mailing Address - Street 1:107 PEREGRINE PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:PA
Mailing Address - Zip Code:17517-9136
Mailing Address - Country:US
Mailing Address - Phone:717-283-5688
Mailing Address - Fax:
Practice Address - Street 1:500 CREEKSIDE DR STE 511-519
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-9217
Practice Address - Country:US
Practice Address - Phone:717-283-5688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-04
Last Update Date:2021-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH-005664103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst