Jacob Alexander Bradshaw
Behavior Analyst in Edmond, OK. Individual provider (NPI-1).
NPI number1013296177
StatusActive
Last updated in NPPESAug 8, 2011
Details
- NPI
- 1013296177
- Entity type
- Individual (NPI-1)
- Name
- Jacob Alexander Bradshaw
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 8, 2011
- Last updated
- Aug 8, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | – | – | Yes |
Practice location
1104 Columbia CourtEdmond, OK 73003
Phone 405-240-7003
Mailing address
1104 Columbia CtEdmond, OK 73003-6149
Phone 405-240-7003
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