Individual
JACOB J CHICAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7920 WYOMING BLVD NE STE A1, ALBUQUERQUE, NM 87109-6020
(505) 420-4126
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
513880782
NM
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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