Individual
JESSI ELIZABETH HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
819 TARA PLZ, PAPILLION, NE 68046-2043
(907) 206-4450
Mailing address
819 TARA PLZ, PAPILLION, NE 68046-2043
(907) 206-4450
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-52190
CO
106S00000X
Behavior Technician
—
—
Other
Enumeration date
07/22/2019
Last updated
01/10/2023
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