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Individual

JAMIE LOREN HERNANDEZ PERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5325 WALL ST, MADISON, WI 53718-7982
(240) 614-1992
Mailing address
6425 BRIDGE RD APT 205, MADISON, WI 53713-1854
(240) 614-1992

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB1148730
GA
106S00000X
Behavior Technician
Primary
BACB1148730
WI

Other

Enumeration date
06/01/2022
Last updated
02/24/2026
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