Gerondale, Jacob
Gerondale, Jacob is an individual health care provider with primary practice located at 12912 Coldwater Rd Ste E , Fort Wayne IN 46845-8871. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Gerondale, Jacob can be contacted via phone (260) 245-1455.Contact Information
Primary practice address
12912 Coldwater Rd Ste E
Fort Wayne IN 46845-8871
Phone: (260) 245-1455
Fax: (317) 815-3861
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1518458256 |
|---|---|
| LBN Legal business name | Gerondale, Jacob |
| Credentials | RBT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 29th, 2018 |
| Last updated | May 29th, 2018 - about 8 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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