Individual
ELLIE JO JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MGC
Contact information
Practice address
1635 AURORA CT, AURORA, CO 80045-2541
(720) 848-2080
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/06/2022
Last updated
11/02/2022
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