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Individual
BRIANNA LYNN JACK
Active
Individual
BRIANNA LYNN JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A,BCBA,LBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BEH001466
AZ
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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