Fay, Jacob Patrick

Fay, Jacob Patrick is an individual health care provider with primary practice located at 3155 N College Ave Ste 108 , Fayetteville AR 72703-3500. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavioral Analyst, Behavioral Health & Social Service Providers / Behavior Technician. Behavioral Health & Social Service Providers / Behavioral Analyst is his primary health care specialty. Fay, Jacob Patrick can be contacted via phone (479) 957-9121.

Contact Information

Primary practice address
3155 N College Ave Ste 108 Fayetteville AR 72703-3500
Phone: (479) 957-9121
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-21-53551 Arkansas
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-19-85301 Arkansas

Profile Details

NPI number 1124651559
LBN Legal business name Fay, Jacob Patrick
Credentials BCBA
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2020
Last updated Oct 5th, 2021 - about 4 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 1124651559 NPPES
Arkansas Other BACB495512 BACB ID

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