Individual
JULIA KELLY NUSBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4400 OLD CANTON RD STE 300, JACKSON, MS 39211-5982
(601) 815-2005
Mailing address
504 CLINTON CENTER DRIVE, CBO - SUITE 4300, CLINTON, MS 39056-5610
(601) 815-2005
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
220034
MS
Other
Enumeration date
10/12/2022
Last updated
10/12/2022
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