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General NPI Number Information
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NPI Number | 1780217984
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Entity Type | Individual
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Provider Name | JACOB MCGEE
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Gender | Male
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Dates
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Enumeration Date | 02/16/2020
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 731 BIELENBERG DR STE 102-104
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City | WOODBURY
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State | MN
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Zip | 55125-1700
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Country | US
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Telephone | 612-439-4653
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Fax |
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Provider Business Mailing Address
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Address Line | 803 LAUREL AVE
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City | HUDSON
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State | WI
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Zip | 54016-1905
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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