Individual
JACOB M SOUDAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
246 E CAMPUS VIEW BLVD, COLUMBUS, OH 43235-4634
(614) 505-3126
Mailing address
2875 OLENTANGY RIVER RD APT 610, COLUMBUS, OH 43202-3514
(614) 772-3517
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
186292
OH
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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