Kellijo Jacobson

NPI #1538985957 in Bosque Farms, New Mexico

Provider Information

NPI Number: 1538985957
Entity Type: Individual
Name: Kellijo Jacobson
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Technician
Enumeration Date: Dec 2, 2024
Last Updated: Dec 2, 2024

Practice Location

Address: 2827 PARKLANE DR
City: Bosque Farms
State: New Mexico
ZIP Code: 87068-8901
Phone: (505) 401-1969

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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