Elly Marie Dorothy Jacob

NPI #1144056094 in Bloomington, Minnesota

Provider Information

NPI Number
1144056094
Entity Type
Individual
Name
Elly Marie Dorothy Jacob
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Behavior Technician
Enumeration Date
Sep 9, 2024
Last Updated
Sep 9, 2024

Practice Location

Address
1801 AMERICAN BLVD E
ZIP Code
55425-1232
Phone
(952) 767-2267

Specialties & Taxonomy Codes

Specialty
Behavior Technician

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