Individual
SAMANTHA JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
8652 E EASTRIDGE RD STE 201, PRESCOTT VALLEY, AZ 86314-9464
(928) 830-2410
Mailing address
3256 W HUNTINGTON DR, PHOENIX, AZ 85041-4339
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
005707
AZ
103TB0200X
Cognitive & Behavioral Psychologist
005707
AZ
103TC0700X
Clinical Psychologist
005507
AZ
Other
Enumeration date
04/08/2026
Last updated
04/08/2026
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