Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1003368234 |
---|---|
Provider Name | Jessica Horne |
First Address | Tinley Park, IL 60477-3936 |
Second Address | Chicago Heights, IL 60411-2463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2016 |
Last Update Date | 04/11/2016 |