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Individual

JACOB SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
(616) 336-8830
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 336-3909
(616) 336-8830

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
0-18-8888
106S00000X
Behavior Technician

Other

Enumeration date
07/19/2016
Last updated
03/23/2022
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