Individual
JENNIFER SARAH MCCULLOCH-KONKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
55349 COUNTY ROAD 15, CARR, CO 80612-8904
(970) 690-0595
Mailing address
7360 N LINCOLN AVE STE 110, LINCOLNWOOD, IL 60712-1705
(970) 690-0595
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31150
CO
Other
Enumeration date
09/09/2019
Last updated
09/09/2019
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