Individual
JAM TIPTON PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
3506 RIDGECREST LN, SAN ANGELO, TX 76904-7260
(325) 374-8570
Mailing address
3506 RIDGECREST LN, SAN ANGELO, TX 76904-7260
(325) 374-8570
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
06/28/2011
Last updated
06/28/2011
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