Individual
MR. JIMMIE R LIVESAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
514 N MAIN ST, JONESBORO, IL 62952-1800
(618) 614-4265
Mailing address
514 N MAIN ST, JONESBORO, IL 62952-1800
(618) 614-4265
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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