Provider Demographics
NPI:1053649210
Name:FRICKE, JESSICA MITCHELL (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:MITCHELL
Last Name:FRICKE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:FAYE
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 HIGHTOWER TRAIL B120
Mailing Address - Street 2:INTERGRATED BEHAVIORAL SOLUTIONS, INC.
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350
Mailing Address - Country:US
Mailing Address - Phone:866-750-5554
Mailing Address - Fax:866-974-5999
Practice Address - Street 1:1215 HIGHTOWER TRAIL B120
Practice Address - Street 2:INTERGRATED BEHAVIORAL SOLUTIONS, INC.
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350
Practice Address - Country:US
Practice Address - Phone:866-750-5554
Practice Address - Fax:866-974-5999
Is Sole Proprietor?:No
Enumeration Date:2009-11-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst