Individual
JASEN M PEKALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5500 MARKET ST STE 119, BOARDMAN, OH 44512-2616
(330) 991-9117
Mailing address
5500 MARKET ST, BOARDMAN, OH 44512-2601
(330) 991-9117
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-222770
OH
Other
Enumeration date
07/15/2022
Last updated
07/15/2022
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