Individual
JACOB FRAGOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4104 OUTLOOK BLVD BLDG B, PUEBLO, CO 81008-1670
(719) 283-1633
Mailing address
2105 ACADEMY CIR, COLORADO SPRINGS, CO 80909-1663
(719) 595-5555
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
CO
106E00000X
Assistant Behavior Analyst
Primary
—
CO
106E00000X
Assistant Behavior Analyst
Primary
—
IL
Other
Enumeration date
07/11/2022
Last updated
06/01/2026
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