Individual
JENNIFER FISHBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2715 INDUSTRIAL ST, JUNCTION CITY, KS 66441-8398
(785) 256-9096
Mailing address
2715 INDUSTRIAL ST, JUNCTION CITY, KS 66441-8398
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-42471
KS
Other
Enumeration date
12/19/2017
Last updated
12/19/2017
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