Individual
AMY MARIE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMLP LCP
Contact information
Practice address
9333 EAST 21ST ST., NORTH, WICHITA, KS 67206-2927
(316) 634-4700
(316) 634-4770
Mailing address
9333 EAST 21ST ST., NORTH, WICHITA, KS 67206-2927
(316) 634-4700
(316) 634-4770
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
0345
KS
Other
Enumeration date
11/18/2005
Last updated
07/08/2007
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