Individual
MELISSA A JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
943 CALLICOON CENTER RD, CALLICOON CENTER, NY 12724-0175
(845) 807-8726
Mailing address
PO BOX 175, CALLICOON CENTER, NY 12724-0175
(845) 807-8726
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
22-462330
NY
Other
Enumeration date
06/03/2016
Last updated
06/03/2016
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