TATE RYLEY JACOBSON

FORT WAYNE, IN
NPI1679288344
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103K00000X Behavior Analyst
(Licence: IN  1-25-80017)
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2023-01-17
Last Update Date2025-09-08
Business Address
-- TATE RYLEY JACOBSON
4422 E STATE BLVD
FORT WAYNE, IN 46815-6917
Phone number: 260-471-9263
Mailing Address
-- TATE RYLEY JACOBSON
3500 DEPAUW BLVD STE 3070
INDIANAPOLIS, IN 46268-6135
Phone number: 855-324-0885
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