Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103K00000X | Behavior Analyst | ||
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1023481884 |
---|---|
Provider Name | Jessica Pyke |
First Address | Okemos, MI 48864-5506 |
Second Address | Jackson, MI 49201-7071 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2015 |
Last Update Date | 14/09/2020 |