Individual
SHAWNA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2812 MACK RD, FAIRFIELD, OH 45014-5130
(513) 813-5327
Mailing address
2812 MACK RD, FAIRFIELD, OH 45014-5130
(513) 813-5327
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
P.07800
OH
Other
Enumeration date
06/06/2019
Last updated
07/29/2025
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