Basic Information
| Provider Information | |||||||||
| NPI: | 1447626551 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GESICK | ||||||||
| FirstName: | JEFFREY | ||||||||
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| Credential: | BCBA, LBA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1280 E HUFFAKER LN | ||||||||
| Address2: | |||||||||
| City: | RENO | ||||||||
| State: | NV | ||||||||
| PostalCode: | 895111412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7752206827 | ||||||||
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| Practice Location | |||||||||
| Address1: | 979 PYRAMID WAY STE 115 | ||||||||
| Address2: | |||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894313172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756578309 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2015 | ||||||||
| LastUpdateDate: | 06/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | LBA0059 | NV | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.