Individual
HEATHER L JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
47 PLEASANT ST, OXFORD, ME 04270-4273
(207) 240-4637
Mailing address
47 PLEASANT ST, OXFORD, ME 04270-4273
(207) 240-4637
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC4877
ME
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC5290
ME
Other
Enumeration date
06/30/2011
Last updated
12/14/2015
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