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NPI Code Detail

MEDICARE: CATHRYN VICTORIA JACO

MEDICARE: CATHRYN VICTORIA JACO
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 Technician

General Provider Information

NPI Number : 1457210155
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHRYN VICTORIA JACO
Provider Business Mailing Address
First Line : 20 S SPRIGG ST
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-6212
Country : US
Telephone Number : 573-651-4177
Fax Number :
Provider Business Practice Location Address
First Line : 20 S SPRIGG ST
Second Line :
City : CAPE GIRARDEAU
State : MO
Zip : 63703-6212
Country : US
Telephone Number : 573-651-4177
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2026
Last Update Date : 01/19/2026

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Directions to “ CATHRYN VICTORIA JACO ” Practice Location

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