Provider Demographics
NPI:1861957763
Name:MARKEN, JESSICA N (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:N
Last Name:MARKEN
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8550 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4200
Mailing Address - Country:US
Mailing Address - Phone:515-630-0274
Mailing Address - Fax:515-630-0066
Practice Address - Street 1:8550 NEW YORK AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4200
Practice Address - Country:US
Practice Address - Phone:515-630-0274
Practice Address - Fax:515-630-0274
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1-19-39690103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst