Mirae Jessup
Behavior Technician in Fayetteville, NC. Individual provider (NPI-1).
NPI number1104700723
StatusActive
Last updated in NPPESAug 5, 2025
Details
- NPI
- 1104700723
- Entity type
- Individual (NPI-1)
- Name
- Mirae Jessup
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 5, 2025
- Certification date
- Aug 5, 2025
- Last updated
- Aug 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
920 Cambridge StFayetteville, NC 28303-5300
Phone 910-493-3555
Mailing address
920 Cambridge StFayetteville, NC 28303-5300
Phone 910-493-3555
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All 1,337 Behavior Technician providers in Fayetteville · All 9,765 providers in Fayetteville
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