Individual
DR. STACY JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3450 E FLETCHER AVE STE 250, TAMPA, FL 33613-4697
(813) 978-9392
(813) 977-2478
Mailing address
3450 E FLETCHER AVE STE 250, TAMPA, FL 33613-4697
(813) 978-9392
(813) 977-2478
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY4397
FL
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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