Individual
MR. DAVID JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
5501 DELMAR BLVD STE 300, SAINT LOUIS, MO 63112-3054
(314) 469-6644
Mailing address
58469 CHILDS RD, SAINT HELENS, OR 97051-3734
(150) 338-8808
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/05/2023
Last updated
09/05/2023
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