Healthcare Provider Details

I. General information

NPI: 1629404371
Provider Name (Legal Business Name): MARQUII JACOBS BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2013
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 BENTON BLVD UNIT 4307
SAVANNAH GA
31407-1176
US

IV. Provider business mailing address

1850 BENTON BLVD UNIT 4307
SAVANNAH GA
31407-1176
US

V. Phone/Fax

Practice location:
  • Phone: 912-373-5613
  • Fax:
Mailing address:
  • Phone: 912-373-5613
  • Fax: 305-597-3863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA001875
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: