Provider Demographics
NPI:1417434580
Name:RUBINSTEIN, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:RUBINSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 S OCEAN BLVD APT 6Y
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND BCH
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2552
Mailing Address - Country:US
Mailing Address - Phone:609-649-9397
Mailing Address - Fax:
Practice Address - Street 1:7600 CABOT DR APT 1508
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4395
Practice Address - Country:US
Practice Address - Phone:609-649-9397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-41993103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst