Provider Demographics
NPI:1891237699
Name:MCLAUGHLIN, JESSICA SUE (BCBA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:SUE
Last Name:MCLAUGHLIN
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 1:10176 CORPORATE SQUARE DR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63132-2924
Mailing Address - Country:US
Mailing Address - Phone:314-432-6200
Mailing Address - Fax:314-432-8894
Practice Address - Street 1:11933 WESTLINE INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63146-3203
Practice Address - Country:US
Practice Address - Phone:314-432-6200
Practice Address - Fax:314-432-8894
Is Sole Proprietor?:No
Enumeration Date:2016-11-09
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016038558103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst