Individual
DR. WENDY LYNN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2650 BAHIA VISTA ST STE 201, SARASOTA, FL 34239-2625
(941) 402-7520
Mailing address
PO BOX 17263, SARASOTA, FL 34276-0263
(941) 402-7520
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY6367
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-0698740
CORPHEALTH
—
01
—
1353547
BEECHSTREET
—
01
—
2068388
CIGNA
—
01
—
275688
MANAGED HEALTH NETWORK
—
01
—
276480-000
AETNA/MAGELLUM
—
Enumeration date
08/30/2006
Last updated
11/10/2020
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