Individual
MRS. CANDICE LEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDC I
Contact information
Practice address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 486-9800
Mailing address
3449 E REZANOF DR, KODIAK, AK 99615-6952
(907) 486-9800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
AK
Other
Enumeration date
05/13/2019
Last updated
07/20/2022
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