Individual
JELISIA JEMAE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 BROTHERS BLVD, RED OAK, TX 75154-6152
(469) 673-8867
Mailing address
833 BROCKDEN DR, MESQUITE, TX 75149-3275
(952) 393-7755
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-49405
TX
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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