Jacob Kyle Richard

NPI #1194465765 in Norton Shores, Michigan

Provider Information

NPI Number: 1194465765
Entity Type: Individual
Name: Jacob Kyle Richard
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 31, 2022
Last Updated: Mar 31, 2022

Practice Location

Address: 640 SEMINOLE RD
City: Norton Shores
State: Michigan
ZIP Code: 49441-4720
Phone: (231) 724-1111

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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