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Individual

JACEY JANICKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3351 EASTBROOK DR STE 101, FORT COLLINS, CO 80525-5744
(720) 677-1100
Mailing address
2013 WESTVIEW RD, FORT COLLINS, CO 80524-1852
(970) 689-1117

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-70480
CO
106S00000X
Behavior Technician
CO

Other

Enumeration date
09/30/2021
Last updated
01/12/2024
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