Provider Demographics
NPI:1881125904
Name:CORDIER, JESSICA (PHD, BCBA-D)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:CORDIER
Suffix:
Gender:F
Credentials:PHD, BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 POST RD
Mailing Address - Street 2:3RD FL
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4525
Mailing Address - Country:US
Mailing Address - Phone:203-883-8827
Mailing Address - Fax:
Practice Address - Street 1:972 POST RD
Practice Address - Street 2:3RD FL
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4525
Practice Address - Country:US
Practice Address - Phone:203-883-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1-10-7299103K00000X
NY000411103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst