MIRAE JESSUP
Behavior Technician
Active
Individual
NPI: 1104700723
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Behavior Technician | 106S00000X | Yes | - |
Frequently Asked Questions
NPI 1104700723 is the National Provider Identifier for MIRAE JESSUP, a Behavior Technician provider located in Fayetteville, NC. This NPI was enumerated on August 5, 2025.
MIRAE JESSUP practices at 920 CAMBRIDGE ST, Fayetteville, NC 28303.
Quick Facts
- NPI
- 1104700723
- Type
- Individual
- Enumerated
- Aug 5, 2025
- Last Updated
- Aug 5, 2025
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