Provider Demographics
NPI:1356698203
Name:VANCE-MORGAN, JESSIKA CORDELL (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JESSIKA
Middle Name:CORDELL
Last Name:VANCE-MORGAN
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 1:932 WOODGLEN CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40515-5094
Mailing Address - Country:US
Mailing Address - Phone:859-588-4116
Mailing Address - Fax:
Practice Address - Street 1:932 WOODGLEN CT
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40515-5094
Practice Address - Country:US
Practice Address - Phone:859-588-4116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst