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Individual

REBA WILLIAMS JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
17160 N.MAGNOLIA DR., DOLAN SPRING, AZ 86441
(928) 767-3855
Mailing address
P.O.BOX 203, 15893 N.EDGEMONT DR., DOLAN SPRINGS, AZ 86441
(928) 671-0709

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
374U00000X
Home Health Aide

Other

Enumeration date
04/14/2009
Last updated
09/20/2009
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