Healthcare Provider Details

I. General information

NPI: 1962831362
Provider Name (Legal Business Name): JESSICA A CHMYZINSKI EDS., BCBA, LABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 MAIN ST STE 121
AMHERST MA
01002-2347
US

IV. Provider business mailing address

9 HUNT RD
NEW SALEM MA
01355-5507
US

V. Phone/Fax

Practice location:
  • Phone: 413-461-7120
  • Fax: 610-862-9094
Mailing address:
  • Phone: 413-218-9918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: