Individual
DANIEL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
570 BARNARD AVE, WOODMERE, NY 11598
(516) 458-8559
Mailing address
570 BARNARD AVE, WOODMERE, NY 11598
(516) 458-8559
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016493-1
NY
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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