Individual
JARED JOHN DOUGLASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11844 BANDERA RD # 201, HELOTES, TX 78023-4132
(210) 319-9807
Mailing address
4400 HORIZON HILL BLVD APT 901, SAN ANTONIO, TX 78229-2236
(915) 540-4365
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
3177
TX
Other
Enumeration date
02/19/2020
Last updated
02/19/2020
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