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Individual

LINDSAY DIANE JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, M.ED, AVT

Contact information

Practice address
825 S TAYLOR AVE, SAINT LOUIS, MO 63110-1567
(314) 977-0132
Mailing address
7409 KENRICK POINTE DR, SAINT LOUIS, MO 63119-4430
(612) 237-3424

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
12/11/2020
Last updated
12/11/2020
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