Individual
ASHLEY NICOLE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9887 4TH ST N STE 319, ST PETERSBURG, FL 33702-8445
(727) 490-8665
Mailing address
430 3RD AVE S APT 278, ST PETERSBURG, FL 33701-4186
(352) 989-0891
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY12361
FL
Other
Enumeration date
09/16/2022
Last updated
09/03/2024
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