Individual
MALLORY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
107 WESTPARK BLVD STE 140, COLUMBIA, SC 29210-3871
(803) 322-7895
Mailing address
107 WESTPARK BLVD STE 140, COLUMBIA, SC 29210-3871
(803) 322-7895
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17454
SC
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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