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Individual

JESSENIA JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
42 BROOK AVE, BOSTON, MA 02119-3309
(774) 223-3115
Mailing address
42 BROOK AVE, BOSTON, MA 02119-3309

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
01/06/2025
Last updated
01/06/2025
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