Individual
CECILIA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2188 GATEWAY DR, FAIRBORN, OH 45324-6356
(937) 320-5859
(937) 426-1349
Mailing address
2188 GATEWAY DR, FAIRBORN, OH 45324-6356
(937) 320-5859
(937) 426-1349
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5332
OH
Other
Enumeration date
08/22/2005
Last updated
03/27/2008
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