Provider Demographics
NPI:1356016174
Name:PRATT, JESSICA-ANN M (BCABA)
Entity Type:Individual
Prefix:
First Name:JESSICA-ANN
Middle Name:M
Last Name:PRATT
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 JAPONICA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-4968
Mailing Address - Country:US
Mailing Address - Phone:321-972-4039
Mailing Address - Fax:
Practice Address - Street 1:3200 S HIAWASSEE RD SUITE 203, ROOM 1248
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835
Practice Address - Country:US
Practice Address - Phone:321-972-4039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst