Individual
JESSICA LIEVENSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 SWAN ST, BEVERLY, MA 01915-3120
(410) 404-7629
Mailing address
16 SWAN ST, BEVERLY, MA 01915-3120
(410) 404-7629
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-14420
MA
Other
Enumeration date
05/01/2018
Last updated
05/01/2018
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