Provider Demographics
NPI:1184284838
Name:YOON, JESSICA (PHD, BCBA, NYS-LBA)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:YOON
Suffix:
Gender:F
Credentials:PHD, BCBA, NYS-LBA
Other - Prefix:DR
Other - First Name:SANG EUN
Other - Middle Name:
Other - Last Name:YOON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, BCBA, NYS-LBA
Mailing Address - Street 1:225 BROADWAY STE 2710
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-3032
Mailing Address - Country:US
Mailing Address - Phone:646-875-8853
Mailing Address - Fax:855-300-2457
Practice Address - Street 1:225 BROADWAY STE 2710
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-3032
Practice Address - Country:US
Practice Address - Phone:646-875-8853
Practice Address - Fax:855-300-2457
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-15
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001673103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst