Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | ||
N | 156F00000X | Technician/Technologist |
NPI | 1265991095 |
---|---|
Provider Name | Jessica Zink |
First Address | Stuart, FL 34997-7462 |
Second Address | Grand Rapids, MI 49506-3155 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2019 |
Last Update Date | 21/10/2020 |