Provider Demographics
NPI:1952163727
Name:LAFRAMBOISE, JACOB D (MED, RBT)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:D
Last Name:LAFRAMBOISE
Suffix:
Gender:M
Credentials:MED, RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4861 DUCK CREEK ROAD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-1421
Mailing Address - Country:US
Mailing Address - Phone:513-832-2884
Mailing Address - Fax:317-520-8200
Practice Address - Street 1:4861 DUCK CREEK ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-1421
Practice Address - Country:US
Practice Address - Phone:513-832-2884
Practice Address - Fax:317-520-8200
Is Sole Proprietor?:No
Enumeration Date:2024-01-26
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-23-285834106S00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician