Most Relevant Information
Provider Data
| NPI Number: | 1003389511 |
| Provider Name: | JESSICA BALDWIN |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/08/2019 |
| Last Updated: | 04/16/2019 |
Provider Practice Location
201 W MAIN ST STE 4B
MEDFORD
OR
975012734
Practice Location Phone/Fax
| Phone: | 5414141753 |
| Fax: |
Provider Mailing Location
201 W MAIN ST STE 4B
MEDFORD
OR
975012734
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |