Healthcare Provider Details

I. General information

NPI: 1588207781
Provider Name (Legal Business Name): JESSICA E AIKEN BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 MAGNOLIA VILLAGE WAY
LELAND NC
28451-9464
US

IV. Provider business mailing address

1440 LEWIS LANDING AVE
WILMINGTON NC
28405-4483
US

V. Phone/Fax

Practice location:
  • Phone: 910-599-2230
  • Fax:
Mailing address:
  • Phone: 910-751-0279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-90865
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: