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Organization

HOWARD A JACOBSON PHD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. HOWARD A JACOBSON PHD (PRESIDENT)
(864) 546-7315
Entity
Organization

Contact information

Practice address
1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
(864) 546-7315
Mailing address
1025 VERDAE BLVD, SUITE A, GREENVILLE, SC 29607-4032
(864) 546-7315

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
1110
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3682434
TN
Enumeration date
04/15/2008
Last updated
01/04/2010
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