Provider Demographics
NPI:1336677251
Name:ACUNA, JESSICA (BCBA)
Entity type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:
Last Name:ACUNA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3252 MAPLE AVE APT BA
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2813
Mailing Address - Country:US
Mailing Address - Phone:702-738-8476
Mailing Address - Fax:
Practice Address - Street 1:718 OGDEN AVE UPPR 200
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-2930
Practice Address - Country:US
Practice Address - Phone:708-274-7278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRBT-17-34393106S00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician