Individual
KRISTINE M JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
8800 WASHINGTON AVE, SUITE 100, MOUNT PLEASANT, WI 53406-3701
(262) 633-3591
(262) 633-2619
Mailing address
9000 W WISCONSIN AVE, MS 958, MILWAUKEE, WI 53226-4874
(414) 266-7615
(414) 266-6238
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8333-123
WI
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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