Individual
DR. HARVEY EARL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
7400 BEAUFONT SPRINGS DR, SUITE 401, NORTH CHESTERFIELD, VA 23225-5556
(804) 323-5560
(804) 323-5562
Mailing address
3990 REEDS LANDING CIR, MIDLOTHIAN, VA 23113-1385
(804) 814-0609
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
3198
NC
103TC0700X
Clinical Psychologist
Primary
0810-002607
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010116261
—
VA
05
—
010139759
—
VA
Enumeration date
03/05/2006
Last updated
11/28/2012
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