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NPI Code Detail

MEDICARE: LAURA JACOBSON

MEDICARE: LAURA JACOBSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-25-85760MN

General Provider Information

NPI Number : 1255000865
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA JACOBSON
Provider Business Mailing Address
First Line : 3007 HARBOR LN N STE 1200
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-5138
Country : US
Telephone Number : 651-627-6881
Fax Number :
Provider Business Practice Location Address
First Line : 3007 HARBOR LN N STE 1200
Second Line :
City : PLYMOUTH
State : MN
Zip : 55447-5138
Country : US
Telephone Number : 651-627-6881
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 12/03/2025

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Directions to “ LAURA JACOBSON ” Practice Location

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