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NPI Code Detail

MEDICARE: BRIANA D. JACOBS BCBA/LBA

MEDICARE: BRIANA D. JACOBS 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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1629407614
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANA D. JACOBS BCBA/LBA
Provider Business Mailing Address
First Line : 7108 S KANNER HWY
Second Line :
City : STUART
State : FL
Zip : 34997-7462
Country : US
Telephone Number : 855-832-6727
Fax Number :
Provider Business Practice Location Address
First Line : 600 STEWART ST STE 300
Second Line :
City : SEATTLE
State : WA
Zip : 98101-1257
Country : US
Telephone Number : 206-890-6577
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2013
Last Update Date : 08/22/2023

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