Individual
JACLYN ANNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
116 W SHERMAN WAY STE 1, NIXA, MO 65714-9022
(472) 298-0984
(417) 374-7185
Mailing address
116 W SHERMAN WAY STE 1, NIXA, MO 65714-9022
(417) 298-0984
(417) 374-7185
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-321967
MO
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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