Provider Demographics
NPI:1750893939
Name:UZONYI, JESSICA ESTELLE (BCBA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ESTELLE
Last Name:UZONYI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:ESTELLE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16 DAMATO DR
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CT
Mailing Address - Zip Code:06370-1692
Mailing Address - Country:US
Mailing Address - Phone:860-501-8066
Mailing Address - Fax:
Practice Address - Street 1:16 DAMATO DR
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CT
Practice Address - Zip Code:06370-1692
Practice Address - Country:US
Practice Address - Phone:860-501-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-28
Last Update Date:2017-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-15-19398103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst