Individual
IRENE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
Mailing address
1440 RUSSELL RD, PAOLI, PA 19301-1236
(610) 644-6464
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW013486
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2320836000
IBC
PA
01
—
7624296
AETNA
PA
Enumeration date
08/31/2006
Last updated
07/08/2007
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