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Individual

MRS. CAROL JOY JACOB

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LMHC

Contact information

Practice address
1129 W MAIN ST, SUITE 194, MONROE, WA 98272-2034
(206) 617-1574
Mailing address
3307 174TH PL SE, BOTHELL, WA 98012-8532
(425) 487-9369

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH00010383
WA

Other

Enumeration date
10/30/2007
Last updated
10/30/2007
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