Individual
MR. JACOB MICHAEL WRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1409 W CARROLL AVE, CHICAGO, IL 60607-1105
(312) 733-0883
Mailing address
232 WINDY OAK DR, HEBRON, IN 46341-9768
(219) 765-0016
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/20/2020
Last updated
08/28/2020
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