Provider Demographics
NPI:1962831362
Name:CHMYZINSKI, JESSICA A (EDS, BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:CHMYZINSKI
Suffix:
Gender:F
Credentials:EDS, BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:NEW SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01355-5507
Mailing Address - Country:US
Mailing Address - Phone:413-218-9918
Mailing Address - Fax:
Practice Address - Street 1:409 MAIN ST STE 121
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-2347
Practice Address - Country:US
Practice Address - Phone:413-461-7120
Practice Address - Fax:610-862-9094
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty