Individual
JACQUE LYNN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 CANTERBURY DR, HAYS, KS 67601-2345
(785) 628-3241
Mailing address
126 JOLIET ST, GORHAM, KS 67640
(785) 637-5522
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2641
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116219
BLUE CROSS BLUE SHIELD
KS
Enumeration date
03/29/2007
Last updated
02/06/2023
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