Individual
MS. LESLEY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8720 WINDSOR LAKE BLVD APT 905, COLUMBIA, SC 29223-2618
(803) 351-9508
Mailing address
8720 WINDSOR LAKE BLVD APT 905, COLUMBIA, SC 29223-2618
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10693
SC
Other
Enumeration date
08/21/2015
Last updated
08/21/2015
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