Individual
MS. GEORGE R JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1155 N MAYFAIR RD, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Mailing address
1155 N MAYFAIR RD, DEPARTMENT OF PSYCHIATRY, MILWAUKEE, WI 53226-3462
(414) 955-8900
(414) 955-6285
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0482
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811948656
—
WI
Enumeration date
05/15/2006
Last updated
02/07/2013
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