Individual
LISA JONES PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1510 SUNFLOWER DR, MISSOULA, MT 59802-3306
(406) 218-8809
Mailing address
1510 SUNFLOWER DR, MISSOULA, MT 59802-3306
(406) 218-8809
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-11-8586
MT
Other
Enumeration date
01/06/2014
Last updated
03/04/2020
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