Individual
MS. JERYL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
709 MILL ST, THE ALPHA CENTER, CAMDEN, SC 29020-4738
(803) 432-6902
(803) 432-6890
Mailing address
709 MILL ST, THE ALPHA CENTER, CAMDEN, SC 29020-4738
(803) 432-6902
(803) 432-6890
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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