Individual
DR. MICHAEL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
6800 WISCONSIN AVE, CHEVY CHASE, MD 20815-6105
(917) 426-3538
Mailing address
11 KRISTY DR, BETHEL, CT 06801-3001
(860) 712-0663
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
025590-01
NY
103TC0700X
Clinical Psychologist
06770
MD
103TC0700X
Clinical Psychologist
4481
CT
Other
Enumeration date
11/03/2022
Last updated
11/10/2023
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