Healthcare Provider Details
I. General information
NPI: 1548983794
Provider Name (Legal Business Name): CLAUDIA WITTICH JESSEE BCBA/LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/22/2022
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4784B EASTERN AVE
CINCINNATI OH
45226-1812
US
IV. Provider business mailing address
800 W WOODLAWN AVE
LOUISVILLE KY
40215-2472
US
V. Phone/Fax
- Phone: 513-202-4298
- Fax:
- Phone: 502-409-7181
- Fax: 888-450-0935
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 280433 |
| License Number State | KY |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | COBA.01447 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: