Individual
JACOB SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
401 CENTER ST FRNT B, IRONTON, OH 45638-1519
(740) 479-5135
Mailing address
401 CENTER ST FRNT B, IRONTON, OH 45638-1519
(740) 479-5135
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.187510
OH
171M00000X
Case Manager/Care Coordinator
—
OH
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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