Jeremy Cole, BCABA

Individual provider Active NPI Behavior Analyst · St. Marys, GA

NPI 1679975783 · NPPES record last updated Sep 19, 2014

Key facts

NPI
1679975783
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Analyst 103K00000X
Practice address
921 Charlie Smith Sr. Highway
St. Marys, GA 31558
Phone
(912) 576-7070
Fax
(904) 538-0714
NPI assigned
Sep 19, 2014
Sex
Male
Sole proprietor
Yes

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)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Yes

Addresses

Primary practice location

921 Charlie Smith Sr. Highway
St. Marys, GA 31558

Mailing address

10175 Fortune Parkway
Suite 903
Jacksonville, FL 32256
Phone (904) 538-0713

Other providers in St. Marys, GA

All providers in St. Marys, GA · Behavior Analyst in Georgia

Sources for this page

Verify at the official NPI Registry.