Tate Ryley Jacobson

NPI #1679288344 in Fort Wayne, Indiana

Provider Information

NPI Number: 1679288344
Entity Type: Individual
Name: Tate Ryley Jacobson
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Analyst
Enumeration Date: Jan 17, 2023
Last Updated: Sep 8, 2025

Practice Location

Address: 4422 E STATE BLVD
City: Fort Wayne
State: Indiana
ZIP Code: 46815-6917
Phone: (260) 471-9263

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary
Behavior Technician	106S00000X

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