Individual
TRAVIS JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5505 ALSON DR APT 161A, NORFOLK, VA 23508-1541
(336) 686-2145
Mailing address
5505 ALSON DR APT 161A, NORFOLK, VA 23508-1541
(336) 686-2145
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0704016636
VA
Other
Enumeration date
05/11/2026
Last updated
05/11/2026
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