Individual
WILLIAM JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C.C.
Contact information
Practice address
1127 ALAMEDA BLVD NW STE C, ALBUQUERQUE, NM 87114-1240
(505) 379-0810
(520) 201-0179
Mailing address
8608 CLARIDGE PL NW, ALBUQUERQUE, NM 87114-6209
(505) 379-0810
(520) 203-0179
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0065602
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4232782
—
NM
Enumeration date
06/10/2006
Last updated
09/30/2009
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