Individual
AMY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8180 W 4TH AVE APT M205, KENNEWICK, WA 99336-7522
(360) 562-5405
Mailing address
8019 NE 13TH AVE, VANCOUVER, WA 98665-9604
(360) 784-0076
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61185169
WA
Other
Enumeration date
09/23/2022
Last updated
09/23/2022
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