Provider Demographics
NPI:1649583709
Name:SINGER, JACOB (ABA)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:SINGER
Suffix:
Gender:M
Credentials:ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4219
Mailing Address - Country:US
Mailing Address - Phone:940-322-2372
Mailing Address - Fax:940-322-3578
Practice Address - Street 1:1800 ROSE ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4219
Practice Address - Country:US
Practice Address - Phone:940-322-2372
Practice Address - Fax:940-322-3578
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst