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NPI Code Detail

MEDICARE: JESSICA JUDD BATES

MEDICARE: JESSICA JUDD BATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1003621491
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JUDD BATES
Provider Business Mailing Address
First Line : 1143 E 181ST ST
Second Line :
City : WESTFIELD
State : IN
Zip : 46074-8926
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15570 STONY CREEK WAY
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-4385
Country : US
Telephone Number : 317-732-5717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2025
Last Update Date : 02/11/2025

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Directions to “ JESSICA JUDD BATES ” Practice Location

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