Jimmie R Livesay BCBA

NPI 1336260256 - Psychologist - 103TM1800X

NPI Details
NPI 1336260256
Gender Male
Enumeration Date 04/02/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
514 N MAIN ST
JONESBORO IL, 62952-1800, US
Phone (618) 614-4265
Fax
Business Location
514 N MAIN ST
JONESBORO IL, 62952-1800, US
Phone (618) 614-4265
Fax
Toxanomy
Taxonomy Code 103TM1800X
License State
License Number
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According to our database, Mr. Jimmie R Livesay BCBA NPI is 1336260256, taxonomy code is 103TM1800X Jimmie R Livesay BCBA physically located at 514 N Main St, Jonesboro IL, 62952-1800. NPI Number Jimmie R Livesay BCBA has the Individual type.

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1336260256 NPI number is provided on an as is basis without warranty of any kind. 1336260256 is maintained by the National Plan & Provider Enumeration System. The contents of Jimmie R Livesay BCBA are for informational purposes only.