Provider Demographics
NPI:1598565616
Name:LEACH, JESSICA (BCBA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:LEACH
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17921-9264
Mailing Address - Country:US
Mailing Address - Phone:484-362-8873
Mailing Address - Fax:
Practice Address - Street 1:9 BRISTOL CT
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1851
Practice Address - Country:US
Practice Address - Phone:610-350-4429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH007626103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst