Individual
JACOB HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
733 HASTINGS DR, BUFFALO GROVE, IL 60089-6906
(224) 676-0202
Mailing address
909 W CORNELIA AVE APT 2N, CHICAGO, IL 60657-1787
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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