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Individual

MR. COTTRELL LAMAR JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
9430 BROADWAY ST STE 120, PEARLAND, TX 77584-8075
(281) 824-1480
(281) 220-6407
Mailing address
1612 CALLAWAY DR, ALVIN, TX 77511-3743
(281) 824-1480
(281) 220-6407

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
66456
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
66456
LICENSE PROFESSIONAL COUNSELOR
TX
Enumeration date
05/30/2012
Last updated
05/22/2024
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