Individual
DR. MARTIN ALLEN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
10 CONCORD ROAD, SUNBURY, MA 01776-0095
(978) 443-4601
(978) 443-4602
Mailing address
10 CONCORD ROAD, PO BOX 95, SUNBURY, MA 01776-0095
(978) 443-4601
(978) 443-4602
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
250
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JAWW0050
BLUESHIELD
MA
Enumeration date
02/05/2007
Last updated
07/08/2007
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