Individual
DR. PAUL C JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
24255 W 13 MILE RD, SUITE 280, BINGHAM FARMS, MI 48025-4320
(248) 723-2757
(248) 723-2707
Mailing address
24255 W 13 MILE RD, SUITE 280, BINGHAM FARMS, MI 48025-4320
(248) 723-2757
(248) 723-2707
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301001260
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O F3 4670
BLUE CROSS/BLUE SHIELD
MI
Enumeration date
11/01/2006
Last updated
07/08/2007
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