Individual
MR. JACOB LEONARD BARBA SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2960 RODEO PARK DR. WEST, SANTA FE, NM 87505-6351
(505) 986-9633
Mailing address
2960 RODEO PARK DR.WEST, SANTA FE, NM 87505-6351
(505) 986-9633
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
BEHAVIORIAL HEALTH SERVICES
NM
Enumeration date
09/05/2012
Last updated
09/05/2012
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