Individual
JACOB JEBEDIAH SLOSAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1605 NW 1ST ST, BEND, OR 97703-1805
(618) 971-3791
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
ABA-IN-10230483
OR
106S00000X
Behavior Technician
—
—
Other
Enumeration date
02/16/2023
Last updated
03/06/2023
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