Doctor Name: | MR. CODY JAQUES |
NPI Number: | 1659734309 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | B.A |
License Number: | C.1600143-TRNE |
Business Practice Address: | 6081 Jennagate Ln Huber Heights, OH - 454246431 |
Business Phone Number: | 9376818322 |
Business Fax Number: | |
Mailing Address: | 6081 Jennagate Ln, HUBER HEIGHTS |
State: | OH |
Postal Code: | 454246431 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/31/2016 |
NPI Last Update Date: | 03/31/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | C.1600143-TRNE |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |