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Individual

MRS. MARISSA JO LUMPKIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
535 MAINE ST STE 13, QUINCY, IL 62301-3950
(217) 577-2176
(888) 216-1181
Mailing address
535 MAINE ST STE 13, QUINCY, IL 62301-3950
(217) 577-2176
(888) 216-1181

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-69856

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-23-69856
BEHAVIOR ANALYST CERTIFICATION BOARD
01
BACB577742
BEHAVIOR ANALYST CERTIFICATION BOARD
Enumeration date
08/03/2020
Last updated
12/20/2023
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