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General NPI Number Information
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NPI Number | 1326370479
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Entity Type | Individual
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Provider Name | JESSICA BARRETT BYRD BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/31/2010
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Last Update Date | 03/19/2013
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Provider Practice Location Address
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Address Line | 9000 CYPRESS GREEN DR
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7791
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Country | US
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Telephone | 904-732-4343
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Fax |
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Provider Business Mailing Address
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Address Line | 14563 FALLING WATERS DR
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City | JACKSONVILLE
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State | FL
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Zip | 32258-1162
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Country | US
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Telephone | 904-545-2770
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-12-11895
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License Number State | FL
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