Organization
STANLEY S. JACOBS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY S. JACOBS PH.D. (OWNER)
(215) 499-4968
Entity
Organization
Contact information
Practice address
2619 TRENTON RD, #40, LEVITTOWN, PA 19056-1428
(215) 499-4968
Mailing address
2619 TRENTON RD, #40, LEVITTOWN, PA 19056-1428
(215) 499-4968
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
PS002284L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PS002284L
STATE OF PA PSYCHOLOGIST'S LICENSE
PA
Enumeration date
09/19/2016
Last updated
09/21/2016
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