Individual
GREG JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICDC
Contact information
Practice address
530 S MAIN ST, LIMA, OH 45804-1240
(419) 222-1168
(419) 222-2158
Mailing address
530 S MAIN ST, LIMA, OH 45804-1240
(419) 222-1168
(419) 222-2158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
892563
OH
Other
Enumeration date
09/16/2008
Last updated
05/13/2009
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