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Individual
JACOB KEATON
Active
Individual
JACOB KEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
—
NULL
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
164W00000X
WV
373H00000X
Day Training/Habilitation Specialist
—
NULL
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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