Individual
MS. LOIS FAYE JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LADC
Contact information
Practice address
1100 N COLLEGE AVE, BLDG 44, FAYETTEVILLE, AR 72703-1944
(479) 444-5078
Mailing address
1100 N COLLEGE AVE, BLDG 44, FAYETTEVILLE, AR 72703-1944
(479) 444-5078
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
752
OK
1041C0700X
Clinical Social Worker
Primary
4467-C
AR
Other
Enumeration date
02/23/2007
Last updated
09/26/2019
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