Individual
MS. AMY K JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6801090694
MI
1041C0700X
Clinical Social Worker
Primary
6801090694
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
680109064
LICENSED MASTER SOCIAL WORKER
MI
Enumeration date
06/25/2014
Last updated
03/05/2020
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