Individual
KIMBERLY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHRT-C
Contact information
Practice address
180 ACADEMY ST STE 2, PRESQUE ISLE, ME 04769-3183
(207) 764-3319
Mailing address
180 ACADEMY ST STE 3, PRESQUE ISLE, ME 04769-3183
(207) 554-2352
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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