Individual
TAYLOR JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
125 INDIAN LOOKOUT DR, LANDER, WY 82520-3057
(307) 438-1039
Mailing address
125 INDIAN LOOKOUT DR, LANDER, WY 82520-3057
(307) 438-1039
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-19964
WY
103T00000X
Psychologist
PTSB63527
WY
103TS0200X
School Psychologist
PTSB63527
WY
Other
Enumeration date
07/21/2016
Last updated
07/28/2016
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