Individual
ALYSSA Y JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
724 PINE ST, SANDPOINT, ID 83864-1654
(208) 263-1843
Mailing address
20413 HIGHWAY 2, SANDPOINT, ID 83864-7357
(229) 548-7081
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP2404
ID
Other
Enumeration date
06/27/2013
Last updated
06/27/2013
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