Harris, Jackie Irene

Harris, Jackie Irene is an individual health care provider with primary practice located at 399 Hospital Ln , Terre Haute IN 47802-4394. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Harris, Jackie Irene can be contacted via phone (812) 645-2308.

Contact Information

Primary practice address
399 Hospital Ln Terre Haute IN 47802-4394
Phone: (812) 645-2308
Fax: (317) 520-8200
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-20-45333

Profile Details

NPI number 1942810874
LBN Legal business name Harris, Jackie Irene
Credentials MA, BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2020
Last updated Mar 23rd, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942810874 NPPES
Other 1-20-45333 BCBA CERTIFICATE

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