Provider Demographics
NPI:1750817789
Name:FLEMING, JESSICA DUANE (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:DUANE
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:HELEY
Other - Last Name:DUANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7113 THREE CHOPT RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3643
Mailing Address - Country:US
Mailing Address - Phone:804-562-9997
Mailing Address - Fax:
Practice Address - Street 1:7113 THREE CHOPT RD
Practice Address - Street 2:SUITE 301
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3643
Practice Address - Country:US
Practice Address - Phone:804-562-9997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133000759103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst