Organization
JACOBSONS LADDER, LLC
Active
Organization
JACOBSONS LADDER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD S JACOBSON (OWNER)
(757) 213-6995
Entity
Organization
Contact information
Practice address
4445 CORPORATION LN, STE 153, VIRGINIA BEACH, VA 23462-3262
(757) 213-6995
Mailing address
4445 CORPORATION LN, STE 153, VIRGINIA BEACH, VA 23462-3262
(757) 213-6995
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810000305
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7704143
—
VA
Enumeration date
08/19/2011
Last updated
08/19/2011
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