| NPI | 1487007969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR JACOBS Owner 307-438-1039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: WY 1-15-19964) |
| Additional Taxonomies | 103TS0200X Psychologist, School (Licence: WY PTSB63527) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2016-07-19 |