Individual
COLLEEN DAWN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PLADC
Contact information
Practice address
4110 AVENUE D, SCOTTSBLUFF, NE 69361-4650
(308) 635-3171
(308) 635-7026
Mailing address
4110 AVENUE D, SCOTTSBLUFF, NE 69361-4650
(308) 635-3171
(308) 635-7026
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
P-545
NE
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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