Individual
JOAN PARKS JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 ABBEY LN, DANBURY, CT 06810-5230
(914) 646-1188
Mailing address
679 TITICUS ROAD, NORTH SALEM, NY 10560
(914) 646-1188
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
663744
NY
1041C0700X
Clinical Social Worker
Primary
10956
CT
Other
Enumeration date
08/26/2014
Last updated
03/16/2020
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