Individual
JESSICA G BAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
522 E MAIN ST, MASCOUTAH, IL 62258-2240
(618) 566-0313
Mailing address
4206 BEDFORD CREEK LN, WENTZVILLE, MO 63385-2975
(636) 312-0849
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-6407
MO
106S00000X
Behavior Technician
RBT-19-106643
MO
Other
Enumeration date
06/23/2021
Last updated
03/10/2023
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