Individual
JACOB DAVID LANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
3995 COSGRAY RD, HILLIARD, OH 43026-9880
(614) 293-9600
(614) 366-1215
Mailing address
700 ACKERMAN RD STE 2120, COLUMBUS, OH 43202-1559
(614) 293-9600
(614) 366-1215
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
5210-57
WI
103T00000X
Psychologist
Primary
P.08761
OH
103TC0700X
Clinical Psychologist
117530
IA
103TC0700X
Clinical Psychologist
Primary
5210-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609658624
—
WI
Enumeration date
10/16/2023
Last updated
05/05/2026
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