Provider Demographics
NPI:1023799970
Name:MCDEVITT, JACOB DAVID (BCABA)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:DAVID
Last Name:MCDEVITT
Suffix:
Gender:M
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 MIDDLE RD APT B8
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:PA
Mailing Address - Zip Code:18917-2437
Mailing Address - Country:US
Mailing Address - Phone:215-760-8834
Mailing Address - Fax:
Practice Address - Street 1:136 MIDDLE RD APT B8
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:PA
Practice Address - Zip Code:18917-2437
Practice Address - Country:US
Practice Address - Phone:215-760-8834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst