Individual
LISA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2644 RIVA RD, ANNAPOLIS, MD 21401-7427
(410) 222-5000
Mailing address
6333 RED CEDAR PL, BALTIMORE, MD 21209-3830
(443) 548-3136
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
05128
MD
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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