Individual
DR. JANE JACOBS
Active
Individual
DR. JANE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1428
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
491984
MIN
—
Enumeration date
02/08/2008
Last updated
02/08/2008
Update your record
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