Individual
JAMELL J JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., NCC, PLPC
Contact information
Practice address
111 CHURCH ST, SUITE 103, SAINT LOUIS, MO 63135-2441
(314) 485-7330
Mailing address
3609 THYME DR, SAINT CHARLES, MO 63303-6330
(310) 766-9616
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2015043578
MO
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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