Provider Demographics
NPI:1053636951
Name:ROYER, JESSICA ANNE (BCBA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANNE
Last Name:ROYER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 P ST
Mailing Address - Street 2:
Mailing Address - City:LAKE LOTAWANA
Mailing Address - State:MO
Mailing Address - Zip Code:64086-9445
Mailing Address - Country:US
Mailing Address - Phone:806-501-5138
Mailing Address - Fax:
Practice Address - Street 1:10330 HICKMAN MILLS DR
Practice Address - Street 2:BUILDING II
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64137-1618
Practice Address - Country:US
Practice Address - Phone:816-501-5138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2010-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst