Individual
DR. CHARLES JASON JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
33 SYCAMORE RD, HAVERTOWN, PA 19083-4406
(412) 596-3870
Mailing address
8200 FLOURTOWN AVE, WYNDMOOR, PA 19038-7976
(215) 233-3994
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS017732
PA
Other
Enumeration date
10/15/2007
Last updated
06/01/2023
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