Individual
JESSICA DAWN JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA (KY)
Contact information
Practice address
632 EASTERN BLVD, CLARKSVILLE, IN 47129-2463
(812) 725-9025
Mailing address
632 EASTERN BLVD, CLARKSVILLE, IN 47129-2463
(812) 725-9025
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
RBT-17-34988
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-17-34988
RBT CERTIFICATE
—
Enumeration date
01/02/2020
Last updated
01/20/2022
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