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Individual
MISS JESSI D RAY
Active
Individual
MISS JESSI D RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCABA &CERT. IN ABA
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
0-07-2265
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-07-2265
BCABA CERTIFICATION
CA
Enumeration date
07/18/2008
Last updated
07/18/2008
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