Healthcare Provider Details

I. General information

NPI: 1851021414
Provider Name (Legal Business Name): JESSICA ONONAKU M.A. BCBA LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 JOHNNYCAKE RD STE 106
WINDSOR MILL MD
21244-2419
US

IV. Provider business mailing address

7001 JOHNNYCAKE RD STE 106
WINDSOR MILL MD
21244-2419
US

V. Phone/Fax

Practice location:
  • Phone: 410-774-9840
  • Fax: 833-262-4803
Mailing address:
  • Phone: 410-774-9840
  • Fax: 833-262-4803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA2896
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: