Individual
JASON CARL JACOBIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1169 CALL CREEK PLACE, SUITE B, POCATELLO, ID 83201-3071
(208) 232-7780
Mailing address
1418 FILLMORE ST, TWIN FALLS, ID 83301-3380
(208) 735-2237
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW27236
ID
Other
Enumeration date
01/10/2007
Last updated
07/20/2011
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