Individual
KELLY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18 PARK AVE, MOUNT AIRY, MD 21771-5438
(410) 346-0097
Mailing address
PO BOX 923, MOUNT AIRY, MD 21771-0923
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/30/2020
Last updated
01/30/2020
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