Individual
JACQUETTE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
9050 IRON HORSE LN, APT 121, PIKESVILLE, MD 21208-2154
(240) 468-8476
Mailing address
9050 IRON HORSE LN, APT 121, PIKESVILLE, MD 21208-2154
(240) 468-8476
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC4304
MD
Other
Enumeration date
10/09/2012
Last updated
10/09/2012
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