Individual
MRS. JILL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC
Contact information
Practice address
5007 S HOWELL AVE STE 350, MILWAUKEE, WI 53207-6159
(262) 789-1191
Mailing address
16535 W BLUEMOUND RD STE 200, BROOKFIELD, WI 53005-5906
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2370-125
WI
101YS0200X
School Counselor
173951
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42170300
—
WI
Enumeration date
07/02/2015
Last updated
07/02/2015
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