Individual
JAVIER CORONA-JACOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8282 28TH CT NE STE A, LACEY, WA 98516-7162
(360) 915-8686
Mailing address
3310 HARRISON AVE SPC 1, CENTRALIA, WA 98531-9300
(360) 623-9180
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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