Individual
MR. JACOB WAYNE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
2600 VICTORY PKWY, CINCINNATI, OH 45206-1711
(513) 751-7747
(513) 751-8107
Mailing address
1086 KENSINGTON LN, CINCINNATI, OH 45245-1566
(513) 205-6189
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S. 1100868
OH
Other
Enumeration date
12/23/2013
Last updated
12/23/2013
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