Individual
TAMMI JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
325 S MAIN ST STE 2-4, CHESHIRE, CT 06410-3159
(203) 651-8647
Mailing address
325 S MAIN ST STE 3, CHESHIRE, CT 06410-3159
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1630
CT
Other
Enumeration date
09/12/2025
Last updated
09/12/2025
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