Individual
ASHLEY JERZYKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW, RBT
Contact information
Practice address
4609 GRAPE RD STE D1B, MISHAWAKA, IN 46545-8259
(574) 217-1624
Mailing address
5776 GRAPE RD., PMB 171, MISHWAKA, IN 46545
(574) 217-1624
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-26-87762
IN
104100000X
Social Worker
33010569A
IN
106S00000X
Behavior Technician
RBT-22-136513
IN
Other
Enumeration date
12/20/2024
Last updated
02/18/2026
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