Individual
MS. LYNETTE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
174 MAYFIELD DR, GOOSE CREEK, SC 29445-7301
(843) 410-8348
(888) 417-8523
Mailing address
174 MAYFIELD DR, GOOSE CREEK, SC 29445-7301
(843) 410-8348
(888) 417-8523
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-21768
SC
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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