Individual
MARK JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
234 1/2 WASHINGTON AVE, GRAND HAVEN, MI 49417-3307
(616) 607-4476
Mailing address
518 ADAMS ST, GRAND HAVEN, MI 49417-1029
(616) 990-5556
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301007693
MI
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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