Provider Demographics
NPI:1497205082
Name:NAGY, JESSICA
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:NAGY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:RUSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, MED, EDS NCSP
Mailing Address - Street 1:2073 STABLER RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-6038
Mailing Address - Country:US
Mailing Address - Phone:330-245-8603
Mailing Address - Fax:
Practice Address - Street 1:2073 STABLER RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-6038
Practice Address - Country:US
Practice Address - Phone:330-245-8603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH3083832103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool