Individual
KATHLEEN BOURKE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 W DUNLAP AVE STE 100, PHOENIX, AZ 85021-2813
(602) 325-2485
Mailing address
6916 E MARIPOSA DR, SCOTTSDALE, AZ 85251-1220
(602) 999-1190
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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