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Individual

REGINA MARY JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
527 ROCKLEDGE AVE, HUNTINGDON VALLEY, PA 19006-8511
(215) 880-3447
Mailing address
527 ROCKLEDGE AVE, HUNTINGDON VALLEY, PA 19006-8511
(215) 880-3447

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
BH001222
PA
103K00000X
Behavior Analyst
Primary
BH001222
PA

Other

Enumeration date
02/22/2018
Last updated
02/22/2018
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