Individual
JESSICA BRUNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
4710 PARNELL AVE, FORT WAYNE, IN 46825-5876
(219) 881-8400
Mailing address
5319 WILLOWHURST DR, FORT WAYNE, IN 46835-3609
(260) 443-8434
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-25-80771
IN
Other
Enumeration date
01/22/2025
Last updated
04/28/2025
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