Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106E00000X | Assistant Behavior Analyst |
NPI | 1174021802 |
---|---|
Provider Name | Jessica Skidmore |
First Address | Chillicothe, OH 45601-1104 |
Second Address | Nelsonville, OH 45764-9430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2018 |
Last Update Date | 29/01/2018 |