Healthcare Provider Details

I. General information

NPI: 1114537370
Provider Name (Legal Business Name): JESSICA HARRISON M.ED, BCBA, LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710A JOHN PLATT DR
MOREHEAD CITY NC
28557-4372
US

IV. Provider business mailing address

507 LANYARD DR
NEWPORT NC
28570-5217
US

V. Phone/Fax

Practice location:
  • Phone: 252-777-3140
  • Fax:
Mailing address:
  • Phone: 252-531-7820
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: