Individual
PROF. JESSICA SYLVIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
21 S PARK BLVD, SUITE 21, GREENWOOD, IN 46143-8838
(317) 449-2104
(765) 450-6664
Mailing address
700 E. FIRMIN STREET, SUITE 209, KOKOMO, IN 46902-2375
(765) 454-9748
(765) 450-6664
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
247200000X
Other Technician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-14-17875
BCBA
—
Enumeration date
06/18/2015
Last updated
11/03/2016
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