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Individual

JACOB RAY WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9274 INGLETON, SAN ANTONIO, TX 78245-1659
(210) 672-0564
Mailing address
14317 POTRANCO ROARD SUITE 205, #327, SAN ANTONIO, TX 78253
(210) 672-0564

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-42381
TX
106S00000X
Behavior Technician
RBT-17-36085
TX

Other

Enumeration date
01/29/2018
Last updated
02/20/2023
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