Individual
JORDAN ELIZABETH GOOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1460 NW VIVION RD, KANSAS CITY, MO 64118-4555
(816) 853-0946
(816) 396-8809
Mailing address
1460 NW VIVION RD, KANSAS CITY, MO 64118-4555
(816) 853-0946
(816) 396-8809
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-18-65001
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RBT-18-65001
BEHAVIOR ANALYST CERTIFICATION BOARDS
—
Enumeration date
06/10/2019
Last updated
06/10/2019
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