Individual
MR. JON SCOTT JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
408 RED CEDAR ST, MENOMONIE, WI 54751
(715) 235-4696
(715) 235-3941
Mailing address
M8898 250TH STREET, SPRING VALLEY, WI 54767
(715) 778-4320
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
397124
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39174500
—
WI
Enumeration date
11/22/2006
Last updated
07/08/2007
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