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General NPI Number Information
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NPI Number | 1194682633
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Entity Type | Individual
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Provider Name | JESSICA GASKINS
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 5932 SANDY FORKS RD STE 101
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City | RALEIGH
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State | NC
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Zip | 27609-3814
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Country | US
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Telephone | 984-275-3054
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Fax |
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Provider Business Mailing Address
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Address Line | 721 ROYAL ANNE LN APT 102
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City | RALEIGH
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State | NC
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Zip | 27615-7812
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Country | US
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Telephone | 843-331-0998
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | BACB1281428
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License Number State | SC
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