Individual
DYLAN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 BROWNING RD STE 195, COLUMBIA, SC 29210-6941
(803) 999-9752
Mailing address
1321 MURFREESBORO PIKE STE 410, NASHVILLE, TN 37217-2665
(615) 880-5782
(615) 825-1946
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-257867
SC
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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