Healthcare Provider Details

I. General information

NPI: 1962944165
Provider Name (Legal Business Name): JESSICA HESLING BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA YOUNG

II. Dates (important events)

Enumeration Date: 11/06/2016
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 CANNON DR
BERLIN MD
21811-1730
US

IV. Provider business mailing address

52 CANNON DR
BERLIN MD
21811-1730
US

V. Phone/Fax

Practice location:
  • Phone: 484-757-1565
  • Fax:
Mailing address:
  • Phone: 484-757-1565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-84267
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-18-8913
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: