Individual
JACOB GRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RBT
Contact information
Practice address
13905 TECHNOLOGY DR STE A1, OKLAHOMA CITY, OK 73134-1054
(405) 389-4530
Mailing address
10403 141ST AVE NE, NEWALLA, OK 74857-8119
(580) 399-8882
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/07/2020
Last updated
08/07/2020
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