Provider Demographics
NPI:1497010607
Name:ROBBINS, JESSICA A (BCABA, LABA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:BCABA, LABA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:A
Other - Last Name:WOZNIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCABA
Mailing Address - Street 1:7923 BARTLETT PEAK ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89166-5030
Mailing Address - Country:US
Mailing Address - Phone:413-330-3908
Mailing Address - Fax:
Practice Address - Street 1:3130 S DURANGO DR STE 425
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-4455
Practice Address - Country:US
Practice Address - Phone:702-626-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0-06-2061103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst