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Individual

BENJAMIN JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2100 RAYBROOK ST SE STE 300, GRAND RAPIDS, MI 49546-5783
(616) 235-5100
(616) 235-5050
Mailing address
2100 RAYBROOK ST SE, GRAND RAPIDS, MI 49546-7759
(616) 235-5100
(616) 235-5050

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801095780
MI

Other

Enumeration date
12/20/2018
Last updated
12/20/2018
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