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Individual

ALLISON KAY JACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCABA

Contact information

Practice address
7230 ENGLE RD STE 102, FORT WAYNE, IN 46804-2234
(260) 373-1050
(260) 471-0285
Mailing address
1824 TOUBY PIKE STE B, KOKOMO, IN 46901-2573
(765) 628-7400
(855) 940-0177

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary

Other

Enumeration date
02/17/2021
Last updated
02/17/2021
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