Dietz, Jacob Andrew

Dietz, Jacob Andrew is an individual health care provider with primary practice located at 2904 Foltz Dr , Edgewood KY 41017-2525. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as his primary health care specialty. Dietz, Jacob Andrew can be contacted via phone (859) 795-3000.

Contact Information

Primary practice address
2904 Foltz Dr Edgewood KY 41017-2525
Phone: (859) 795-3000
Fax: (317) 520-8200
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X RBT-19-98801 Kentucky

Profile Details

NPI number 1659922441
LBN Legal business name Dietz, Jacob Andrew
Credentials BA, RBT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 24th, 2019
Last updated Sep 24th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659922441 NPPES
Kentucky Other RBT-19-98801 RBT CERTIFICATE

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