Individual
DR. DENNIS JOSEPH JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5745 W MAPLE RD, SUITE 204, WEST BLOOMFIELD, MI 48322-4468
(248) 626-4611
Mailing address
5745 W MAPLE RD, SUITE 204, WEST BLOOMFIELD, MI 48322-4468
(248) 626-4611
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
098928
MI
Other
Enumeration date
08/13/2006
Last updated
07/08/2007
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