Individual
JESSICA LYNN HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
611 N FOUNTAIN ST, CAPE GIRARDEAU, MO 63701-7244
(573) 339-9300
Mailing address
10176 CORPORATE SQUARE DR, SAINT LOUIS, MO 63132-2924
(314) 432-6100
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-07-3958
MO
Other
Enumeration date
02/04/2008
Last updated
05/15/2015
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