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Individual
JAKE WILLIAM RYAN PETRASZEWSKY
Active
Individual
JAKE WILLIAM RYAN PETRASZEWSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
25-411920
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25-411920
25-411920
—
Enumeration date
02/24/2025
Last updated
02/24/2025
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