Individual
CINDY JACOBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
404 W MATILDA ST, DALTON, GA 30720-8839
(678) 216-5860
Mailing address
404 W MATILDA ST, DALTON, GA 30720-8839
(678) 216-5860
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BACB726159
GA
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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