Individual
LESLIE ANN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,LCSW
Contact information
Practice address
1956 OHIO AVE, CONNERSVILLE, IN 47331-2858
(765) 827-5610
Mailing address
3892 S BASE RD, CONNERSVILLE, IN 47331-8979
(765) 825-3656
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34003274A
IN
Other
Enumeration date
01/19/2007
Last updated
07/08/2007
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