Individual
JACOB LIAM WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1402 SW 12TH AVE APT 1, PORTLAND, OR 97201-3516
(503) 213-0024
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/07/2023
Last updated
11/07/2023
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