Individual
DR. BROOKE REGINA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
548 LONE OAK RD, PADUCAH, KY 42003-4538
(270) 442-6161
Mailing address
5485 LOWER SALEM CHURCH RD, GRAND CHAIN, IL 62941-2003
(618) 771-6495
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.010824
IL
Other
Enumeration date
12/04/2018
Last updated
09/11/2022
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