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Individual

MRS. RYANNE E JACOBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SSP, NCSP, MA

Contact information

Practice address
600 MILLER ST, CARTHAGE, IL 62321-1129
(217) 357-2136
(217) 357-3569
Mailing address
210 S ADAMS ST, CARTHAGE, IL 62321-1420
(217) 357-9202
(217) 357-3755

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2351336
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1063922417
IL
Enumeration date
10/11/2017
Last updated
08/20/2021
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