Organization
MOUNTAIN LAUREL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE ELIZABETH JACOBS LPC, ALPS (COUNSELOR)
(304) 282-7552
Entity
Organization
Contact information
Practice address
235 HIGH ST, SUITE 407, MORGANTOWN, WV 26505-5429
(304) 282-7552
Mailing address
235 HIGH ST, SUITE 407, MORGANTOWN, WV 26505-5429
(304) 282-7552
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1978
WV
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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