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Individual

MS. CHRISTINA JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1742 CHERYL ST, CLARKSDALE, MS 38614-7218
(662) 627-7267
(662) 627-5240
Mailing address
PO BOX 1046, CLARKSDALE, MS 38614-1046
(662) 627-7267
(662) 627-5240

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
MS
101YM0800X
Mental Health Counselor
MS

Other

Enumeration date
07/16/2018
Last updated
07/16/2018
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