Provider Demographics
NPI:1558834440
Name:DOLL, JESSICA MARGARETE (BCBA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARGARETE
Last Name:DOLL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:130 S BUCHANAN ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-5944
Mailing Address - Country:US
Mailing Address - Phone:337-769-3413
Mailing Address - Fax:337-769-3414
Practice Address - Street 1:130 S BUCHANAN ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501
Practice Address - Country:US
Practice Address - Phone:337-769-3413
Practice Address - Fax:337-769-3414
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst