Individual
JUDY GAIL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 WILLIS AVENUE, BOGALUSA MENTAL HEALTH CENTER, BOGALUSA, LA 70427
(985) 732-6610
(985) 732-6626
Mailing address
619 WILLIS AVENUE, BOGALUSA MENTAL HEALTH CENTER, BOGALUSA, LA 70427
(985) 732-6610
(985) 732-6626
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
#910203
LA
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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