Jessica Boisture, RBT
Behavior Technician in Fort Wayne, IN. Individual provider (NPI-1).
NPI number1295542835
StatusActive
Last updated in NPPESDec 17, 2024
Details
- NPI
- 1295542835
- Entity type
- Individual (NPI-1)
- Name
- Jessica Boisture
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 17, 2024
- Certification date
- Dec 17, 2024
- Last updated
- Dec 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Other names
- Jessica Johnson (Former Name)
Practice location
101 W Dupont RdFort Wayne, IN 46825-1915
Phone 260-489-1774
Mailing address
101 W Dupont RdFort Wayne, IN 46825-1915
Phone 260-489-1774
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