Individual
LAURA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
3142 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
(260) 633-3758
(260) 366-6558
Mailing address
3142 MALLARD COVE LN, FORT WAYNE, IN 46804-2882
(260) 633-3758
(260) 366-6558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39003541A
IN
Other
Enumeration date
09/12/2016
Last updated
10/06/2022
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