Individual
MR. WADE STEWART JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSW
Contact information
Practice address
112 CLOVER LANE, HANOVER, PA 17331
(717) 632-0774
(717) 633-5816
Mailing address
111 PENN STREET, HANOVER, PA 17331
(717) 632-0774
(717) 633-5816
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW127361
PA
Other
Enumeration date
08/04/2009
Last updated
08/04/2009
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