Individual
JESSAMYN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
124 CAPULET DR, SAINT AUGUSTINE, FL 32092-4537
(904) 429-3859
(904) 429-4416
Mailing address
175 MIDDLE ST UNIT 1201, LAKE MARY, FL 32746-3625
(866) 610-0580
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/29/2019
Last updated
08/02/2021
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