Jacob David Breaux
Individual provider Active NPI Behavior Technician · Greenwell Springs, LA
NPI 1083260947 · NPPES record last updated Aug 15, 2019
Key facts
- NPI
- 1083260947
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 6338 Morgan Rd
Greenwell Springs, LA 70739-4347 - Phone
- (225) 405-2833
- NPI assigned
- Aug 15, 2019
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
6338 Morgan Rd
Greenwell Springs, LA 70739-4347
Mailing address
6338 Morgan Rd
Greenwell Springs, LA 70739-4347
Phone (225) 405-2833
Other providers in Greenwell Springs, LA
- Benjamin Davis Black
- Arrington Blanchard
- Boston Primary Care LLC
- William Boston
- Richard A Brasseaux
- Hannah Cowart Breckwoldt
- Gregory Allen Brooks Sr.
- Kelekia Michelle Brooks
- Terrence Brooks
- Landon Dale Broussard
All providers in Greenwell Springs, LA · Behavior Technician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.