Individual
JACOB ANDREW BRANUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1651 OLD MEADOW RD STE 600, MC LEAN, VA 22102-4389
(877) 504-4141
Mailing address
4951 BRENMAN PARK DR APT 315, ALEXANDRIA, VA 22304-7799
(571) 550-0822
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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