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NPI Code Detail

MEDICARE: JACOB CLEVELAND ZUVANICH M. ED., BCBA, LBA

MEDICARE: JACOB CLEVELAND ZUVANICH M. ED., BCBA, LBA
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
1106S00000XBehavior TechnicianCB60772043WA
2103K00000XBehavior Analyst

General Provider Information

NPI Number : 1437525698
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACOB CLEVELAND ZUVANICH M. ED., BCBA, LBA
Provider Business Mailing Address
First Line : 2105 E PARK ST
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-4598
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2105 E PARK ST
Second Line :
City : CEDAR PARK
State : TX
Zip : 78613-4598
Country : US
Telephone Number : 512-772-2295
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2015
Last Update Date : 09/01/2023

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