MEDICARE: MR. JACOB ABRAM REEB

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1518733559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JACOB ABRAM REEB

Provider Business Mailing Address
First Line	:	PO BOX 523
Second Line	:
City	:	GNADENHUTTEN
State	:	OH
Zip	:	44629-0523
Country	:	US
Telephone Number	:	724-562-4800
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 NORTH CHERRY ST.
Second Line	:
City	:	GNADENHUTTEN
State	:	OH
Zip	:	44629-0523
Country	:	US
Telephone Number	:	724-562-4800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2023
Last Update Date	:	11/30/2023

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