Provider Demographics
NPI:1982232351
Name:BIGGS, JESSICA LAVANDER (BCBA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LAVANDER
Last Name:BIGGS
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 1:9833 ROSELAND ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-2794
Mailing Address - Country:US
Mailing Address - Phone:734-223-0993
Mailing Address - Fax:
Practice Address - Street 1:28116 ORCHARD LAKE RD STE 100
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3713
Practice Address - Country:US
Practice Address - Phone:248-550-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401001130103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst