NPI 1184044323

Jake Camron Edwards, BCBA

Practitioner Behavior Analyst Williston, VT

Practice location

Address: 37 Talcott Rd Suite 114, Williston, VT 05495-2094
Phone: (802) 662-7831
Fax: (802) 662-7834
Mailing address: 343 Jericho Rd Unit B, Richmond, VT 05477-9173

Registered specialties

Behavior Analyst Primary

Behavioral Health & Social Service Providers Taxonomy 103K00000X Licence 1141598 (VT)

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Registry record

NPI: 1184044323
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Apr 2014
Record last updated: 7 Oct 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.