Individual
MRS. JESSICA LYNNE WAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. ED, BCBA
Contact information
Practice address
610 MANTON AVE, PROVIDENCE, RI 02909-5633
(401) 243-7213
(401) 421-2152
Mailing address
31 GOLD MINE RD, CHEPACHET, RI 02814-1756
(401) 579-9619
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-12759
—
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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