Individual
DONNA WITHEE JACOBS
Active
Individual
DONNA WITHEE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
117190
MA
1041C0700X
Clinical Social Worker
R018814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050800
GHI - GROUP HEALTH INC.
NY
01
—
144811
VALUE OPTIONS
NY
01
—
P407545
OXFORD
NY
Enumeration date
01/20/2007
Last updated
10/30/2012
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