Individual
MRS. JESSICA DAVERIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS ED
Contact information
Practice address
21 ASHFORD DR, LAKE GROVE, NY 11755-2839
(516) 993-0177
Mailing address
296 CLAFLIN CT, FRANKLIN SQUARE, NY 11010-3445
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000371
NY
103K00000X
Behavior Analyst
15BC00011600
NJ
103K00000X
Behavior Analyst
BH007117
PA
174400000X
Specialist
—
—
Other
Enumeration date
06/06/2012
Last updated
10/24/2025
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