Individual
MRS. JESSICA LYNN HEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. BCBA
Contact information
Practice address
1004 HICKORY HILL LN, SUITE 2, HERMITAGE, TN 37076-1930
(615) 939-9313
Mailing address
2408 PLYMOUTH CT, MURFREESBORO, TN 37127-7252
(386) 216-1558
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
75-2690132
TN
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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