Individual
JACQUELYN WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
2430 6TH AVE, MOLINE, IL 61265-1539
(309) 764-5555
Mailing address
2430 6TH AVE, MOLINE, IL 61265-1539
(309) 764-5555
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-59680
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/06/2022
Last updated
06/24/2022
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