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NPI Code Detail

MEDICARE: MISS JACLYN HOOVER BCBA

MEDICARE:  MISS JACLYN  HOOVER  BCBA
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
1103K00000XBehavior Analyst1-18-33079IN

General Provider Information

NPI Number : 1295209955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JACLYN HOOVER BCBA
Provider Business Mailing Address
First Line : 4105 N WALNUT ST
Second Line :
City : MUNCIE
State : IN
Zip : 47303-5904
Country : US
Telephone Number : 765-587-5244
Fax Number : 765-281-6914
Provider Business Practice Location Address
First Line : 4105 N WALNUT ST
Second Line :
City : MUNCIE
State : IN
Zip : 47303-5904
Country : US
Telephone Number : 765-587-5244
Fax Number : 765-281-6914
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2019
Last Update Date : 01/13/2023

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Directions to “ MISS JACLYN HOOVER BCBA” Practice Location

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