Individual
GARY MATTHEW JACOBOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-IT
Contact information
Practice address
1320 MENDOTA ST STE 120, MADISON, WI 53714-1060
(608) 800-1251
Mailing address
1320 MENDOTA ST STE 120, MADISON, WI 53714-1060
(608) 280-2577
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5188-226
WI
Other
Enumeration date
02/23/2022
Last updated
02/23/2022
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