Individual
SHERYL M JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
351 N AIR DEPOT BLVD STE M, MIDWEST CITY, OK 73110-1760
(405) 610-3644
(405) 610-3647
Mailing address
9109 SW 24TH ST, OKLAHOMA CITY, OK 73128-4903
(405) 265-1655
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
06/04/2012
Last updated
02/28/2014
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