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Individual

MRS. JESSICA DIANNE LICHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2227 GODBY RD, ATLANTA, GA 30349-5020
(855) 772-8847
Mailing address
27777 INKSTER RD STE 100, FARMINGTON HILLS, MI 48334-5312

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58490
GA
103K00000X
Behavior Analyst
4962
TX

Other

Enumeration date
02/17/2018
Last updated
09/17/2025
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