Individual
JACOB VINCENT BOURGET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4040 STONE RIDGE RD, ZANESVILLE, OH 43701-0501
(740) 312-1234
Mailing address
4040 STONE RIDGE RD, ZANESVILLE, OH 43701-0501
(740) 312-1234
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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