Jacob Hermes | Appleton, WI • PECOS Search

Jacob Hermes

Behavior Analyst

Behavioral Health & Social Service Providers

5733 W Grande Market Dr, Appleton, WI 54913-8472

PECOS Enrollment

Based on the most recent information from CMS, provider Jacob Hermes does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 12:57 PM.

Profile Details

Provider ID
1871950774
Provider Type
Individual
Full Name
Hermes, Jacob
Credential
BCBA

Gender
Male
Sole Proprietor
Yes
Enumeration Date
1/22/2016
Last Updated
1/22/2016

Contact Information

Practice Location

5733 W Grande Market Dr, Appleton, WI 54913-8472

Unlisted Fax

Mailing Location

5733 W Grande Market Dr, Appleton, WI 54913-8472

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103K00000X Primary	Description Behavior Analyst Behavioral Health & Social Service Providers	License 136 Wisconsin