Individual
MR. JON JAMES SARGEANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCBA
Contact information
Practice address
5617 220TH ST N, FOREST LAKE, MN 55025-9607
(320) 241-3296
Mailing address
5617 220TH ST N, FOREST LAKE, MN 55025-9607
(320) 241-3296
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-15-5860
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-15-5860
BCBA LICENSE NUMBER
MN
Enumeration date
05/07/2021
Last updated
05/07/2021
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