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Individual

JORDAN LILLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1315 S BELL AVE STE 108, AMES, IA 50010-7730
(515) 337-0343
Mailing address
4717 MORTENSEN RD UNIT 103, AMES, IA 50014-6219
(515) 423-3323

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
114642
IA
103K00000X
Behavior Analyst

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-22-61281
BEHAVIOR ANALYST CERTIFICATION BOARD
01
114642
STATE BOARD OF BEHAVIORAL SCIENCE
IA
Enumeration date
09/23/2020
Last updated
09/17/2022
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