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Individual

JACOB FAUST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5351C JAYCEE AVE, HARRISBURG, PA 17112-2997
(717) 657-2080
Mailing address
625 W ELM AVE, HANOVER, PA 17331-5125
(717) 632-4900
(717) 632-4313

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW136781
PA
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
12/11/2014
Last updated
01/17/2020
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