Healthcare Provider Details

I. General information

NPI: 1942137864
Provider Name (Legal Business Name): KRISTEN JESSICA PASTERCZYK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/17/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3564 STONE CREEK DR APT B
CINCINNATI OH
45209-5126
US

IV. Provider business mailing address

3564 STONE CREEK DR APT B
CINCINNATI OH
45209-5126
US

V. Phone/Fax

Practice location:
  • Phone: 908-397-9337
  • Fax:
Mailing address:
  • Phone: 397-937-9337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberUW633489
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: