Provider Demographics
NPI:1053014878
Name:FRIER, JACOB (MED, BCBA, LBA)
Entity type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:FRIER
Suffix:
Gender:
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1338 PARK GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-2011
Mailing Address - Country:US
Mailing Address - Phone:678-371-2893
Mailing Address - Fax:
Practice Address - Street 1:1338 PARK GARDEN LN
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20194-2011
Practice Address - Country:US
Practice Address - Phone:678-371-2893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst