Individual
MR. DONALD EUGENE JOSEPH JACOBSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
31 E VERNON AVE, PHOENIX, AZ 85004-1338
(844) 546-1212
(844) 546-1212
Mailing address
264 S DORAN APT 1, MESA, AZ 85204-2237
(844) 546-1212
(844) 546-1212
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/10/2020
Last updated
10/05/2021
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