| Southeast Behavior Intervention & Consultation | |
|
373 Rylane Jackson MO 63755-8730 | |
| (573) 225-5828 | |
| Not Available |
| Full Name | Southeast Behavior Intervention & Consultation |
|---|---|
| Speciality | Assistant Behavior Analyst |
| Location | 373 Rylane, Jackson, Missouri |
| Authorized Official Name and Position | Jamie Suzanne Brazer (ASSISTANT BEHAVIOR ANALYST) |
| Authorized Official Contact | 5732255828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Behavior Intervention & Consultation 373 Rylane Jackson MO 63755-8730 Ph: (573) 225-5828 | Southeast Behavior Intervention & Consultation 373 Rylane Jackson MO 63755-8730 Ph: (573) 225-5828 |
| NPI Number | 1598327595 |
|---|---|
| Provider Enumeration Date | 07/01/2019 |
| Last Update Date | 07/01/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598327595 | NPI | - | NPPES |
| 730026462 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106E00000X | Assistant Behavior Analyst | (* (Not Available)) | Primary |
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