Individual
JESSICA MARIE ROAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
1495 NE 60 AVE, HOISINGTON, KS 67544-9228
(785) 817-7016
Mailing address
1495 NE 60 AVE, HOISINGTON, KS 67544-9228
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
1-08-4001
KS
Other
Enumeration date
01/12/2023
Last updated
01/12/2023
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