Individual
CHRISTINE MARIE JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
106 W EDWARDS ST, MARYVILLE, MO 64468-2419
(660) 254-1812
Mailing address
106 W. EDWARDS ST, MARYVILLE, MO 64468
(660) 254-1812
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2003018187
MO
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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