Individual
MS. AMY LEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
127 WEST STATE ST, ITHACA, NY 14850-5474
(607) 273-7494
Mailing address
127 W STATE ST, ITHACA, NY 14850-5474
(607) 273-7497
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
078271
NY
Other
Enumeration date
01/08/2007
Last updated
12/22/2011
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