Individual
BERNICE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8180
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(847) 377-8180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149007577
IL
Other
Enumeration date
02/20/2012
Last updated
02/20/2012
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