Individual
REBECCA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2802 HIKES LN, LOUISVILLE, KY 40218-1608
(502) 712-3119
Mailing address
PO BOX 32144, LOUISVILLE, KY 40232-2144
(502) 712-3119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
281080
KY
Other
Enumeration date
02/23/2023
Last updated
02/23/2023
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