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Individual

JESSICA ANN MASON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA, LBA

Contact information

Practice address
1878 SANDHILL RD, WHITLEY CITY, KY 42653-4164
(606) 516-2148
Mailing address
PO BOX 1363, WHITLEY CITY, KY 42653-1363
(606) 516-2148

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
175251
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
175251
KY
Enumeration date
11/07/2017
Last updated
11/07/2017
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