Provider Demographics
NPI:1639732985
Name:SEYLER, JESSICA RAYANN (BCBA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:RAYANN
Last Name:SEYLER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 VAN REED RD APT G10
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1073
Mailing Address - Country:US
Mailing Address - Phone:484-336-5622
Mailing Address - Fax:
Practice Address - Street 1:1904 VAN REED RD APT G10
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1073
Practice Address - Country:US
Practice Address - Phone:484-336-5622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH004073103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst