Provider Demographics
NPI:1871268847
Name:HARTMAN, JESSICA LAUREN (RBT)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LAUREN
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:LAUREN
Other - Last Name:HEWGLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:854 N MOUNT JULIET RD
Mailing Address - Street 2:
Mailing Address - City:MT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-4430
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:854 N MOUNT JULIET RD
Practice Address - Street 2:
Practice Address - City:MT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-4430
Practice Address - Country:US
Practice Address - Phone:615-772-8798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician