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Individual
DOLORES P, JACOBY
Active
Individual
DOLORES P, JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., D. DIV,PH.D.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
604151293
WA
101YP1600X
Pastoral Counselor
Primary
604151293
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
604151293
TRIWEST, VETERAN'S ADMINISTRATION
WA
Enumeration date
09/02/2017
Last updated
07/21/2022
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