Individual
ELIZABETH D JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCCSLP
Contact information
Practice address
600 UNIVERSITY AVE, STE. 110, FAIRBANKS, AK 99709-3643
(907) 451-1067
Mailing address
2025 GREEN LEAF RD, FAIRBANKS, AK 99725-6273
(907) 451-1067
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
155
AK
Other
Enumeration date
05/22/2007
Last updated
05/05/2008
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