Basic Information
| Provider Information | |||||||||
| NPI: | 1184247959 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ZALESKI | ||||||||
| FirstName: | JESSICA | ||||||||
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| Credential: | MA, LBS, BCBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32 RESERVOIR ST | ||||||||
| Address2: | |||||||||
| City: | SIMPSON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184071330 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5709030773 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1081 OAK ST STE 3 | ||||||||
| Address2: | |||||||||
| City: | PITTSTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 186403716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8887264774 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2020 | ||||||||
| LastUpdateDate: | 03/01/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | N | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.