Tad Wesley Jacobs

NPI #1104427723 in Orem, Utah

Provider Information

NPI Number: 1104427723
Entity Type: Individual
Name: Tad Wesley Jacobs
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Nov 2, 2020
Last Updated: Nov 2, 2020

Practice Location

Address: 1250 S 620 W # E1050
City: Orem
State: Utah
ZIP Code: 84058-3326
Phone: (385) 219-7352

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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