Individual
JESSICA JUNE DEMEUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
986 LAKEVIEW DR, GREEN BAY, WI 54313-8818
(920) 544-4970
Mailing address
3313 WIGGINS WAY, GREEN BAY, WI 54311-7263
(920) 495-6191
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-31062
WI
Other
Enumeration date
09/13/2018
Last updated
09/13/2018
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