Individual
MR. JAKE CAMRON EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
37 TALCOTT RD, SUITE 114, WILLISTON, VT 05495-2094
(802) 662-7831
(802) 662-7834
Mailing address
343 JERICHO RD, UNIT B, RICHMOND, VT 05477-9173
(802) 734-5642
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1141598
VT
Other
Enumeration date
04/25/2014
Last updated
10/07/2016
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