Individual
JESSIKA TYLER STUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHP
Contact information
Practice address
2701 17TH ST, CSU DEPARTMENT, ROCK ISLAND, IL 61201
(309) 779-2778
Mailing address
2701 17TH ST, CSU DEPARTMENT, ROCK ISLAND, IL 61201
(309) 779-2778
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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