Individual
DR. MARTHA CANDACE JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3900 HOLLYWOOD BLVD, SUITE 301, HOLLYWOOD, FL 33021-6760
(954) 987-8812
(954) 987-2615
Mailing address
3900 HOLLYWOOD BLVD, SUITE 301, HOLLYWOOD, FL 33021-6760
(954) 987-8812
(954) 987-2615
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY0004227
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
73505
BL CROSS BL SHIELD NUMBER
FL
Enumeration date
03/12/2007
Last updated
07/08/2007
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