Tristen Jessup

NPI #1982154977 in Portage, Michigan

Provider Information

NPI Number: 1982154977
Entity Type: Individual
Name: Tristen Jessup
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Oct 13, 2016
Last Updated: Oct 13, 2016

Practice Location

Address: 1617 E MILHAM AVE
City: Portage
State: Michigan
ZIP Code: 49002-3049
Phone: (269) 303-5931

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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