Provider Demographics
NPI:1093383820
Name:COLE, JARED AUBRY (BS, RBT)
Entity type:Individual
Prefix:
First Name:JARED
Middle Name:AUBRY
Last Name:COLE
Suffix:
Gender:M
Credentials:BS, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3510 HIBISCUS ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32254-1731
Mailing Address - Country:US
Mailing Address - Phone:904-392-5825
Mailing Address - Fax:
Practice Address - Street 1:45 ALABAMA AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-2677
Practice Address - Country:US
Practice Address - Phone:904-420-2304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-17
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician