Individual
DR. LISA JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1750 E FAIRMOUNT AVE, DEPARTMENT OF NEUROPSYCHOLOGY, BALTIMORE, MD 21231-1534
(443) 923-4431
Mailing address
1750 E FAIRMOUNT AVE, DEPARTMENT OF NEUROPSYCHOLOGY, BALTIMORE, MD 21231-1534
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
04872
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/09/2009
Last updated
09/21/2010
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