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General NPI Number Information
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NPI Number | 1568234763
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Entity Type | Individual
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Provider Name | JESSICA KAYLI COBB
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Gender | Female
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Dates
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Enumeration Date | 10/23/2023
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 196 WAVERLY DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4330
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Country | US
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Telephone | 757-450-0383
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Fax | 757-296-0029
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Provider Business Mailing Address
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Address Line | 196 WAVERLY DR
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-4330
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Country | US
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Telephone | 757-450-0383
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Fax | 757-296-0029
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 0133004357
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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