Organization
JACLYN E. JACOBS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN E JACOBS MS, CRC (OWNER)
(304) 549-4215
Entity
Organization
Contact information
Practice address
401 S 2ND ST STE 401, PHILADELPHIA, PA 19147-1612
(267) 388-0465
Mailing address
1500 LOCUST ST APT 1515, PHILADELPHIA, PA 19102-4315
(304) 549-4215
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
01/19/2020
Last updated
01/19/2020
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