Individual
BRITTANY JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1107 NW 4TH ST, GRAND RAPIDS, MN 55744-2205
(218) 326-0095
Mailing address
317 9TH ST NW, CHISHOLM, MN 55719-1540
(218) 966-9276
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
I DONT HAVE ONE YET
MN
Enumeration date
09/29/2022
Last updated
09/29/2022
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