Provider Demographics
NPI:1689156937
Name:PARANCZAK, JESSICA LEE
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEE
Last Name:PARANCZAK
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 1:509 BLACKBIRD DR
Mailing Address - Street 2:
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-2053
Mailing Address - Country:US
Mailing Address - Phone:302-593-5512
Mailing Address - Fax:
Practice Address - Street 1:509 BLACKBIRD DR
Practice Address - Street 2:
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-2053
Practice Address - Country:US
Practice Address - Phone:302-593-5512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst