Individual
SOPHIA NOEL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-6571
Mailing address
619 COLLEGE AVE SE, GRAND RAPIDS, MI 49503-5305
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/15/2024
Last updated
06/15/2024
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