| NPI | 1396245262 |
|---|---|
| Former Name | JESSICA DIANNE KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-22-58490) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: TX 4962) |
| Enumeration Date | 2018-02-17 |
| Last Update Date | 2023-06-26 |