Provider Demographics
NPI:1053971747
Name:BECKNER, JESSALYN C (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JESSALYN
Middle Name:C
Last Name:BECKNER
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 1:395 CHELSEA LOOP
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24073-3063
Mailing Address - Country:US
Mailing Address - Phone:540-808-9355
Mailing Address - Fax:
Practice Address - Street 1:750 IMPERIAL ST
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-5309
Practice Address - Country:US
Practice Address - Phone:540-382-5100
Practice Address - Fax:540-381-6127
Is Sole Proprietor?:No
Enumeration Date:2019-06-16
Last Update Date:2019-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst