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NPI Code Detail

MEDICARE: JESSICA JACOBS

MEDICARE: JESSICA JACOBS
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 : 1881543882
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA JACOBS
Provider Business Mailing Address
First Line : 1405 3RD ST N
Second Line :
City : SARTELL
State : MN
Zip : 56377-1780
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 226 PARK AVE S STE 200
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56301-3713
Country : US
Telephone Number : 320-301-0039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “ JESSICA JACOBS ” Practice Location

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