Individual
BRIAN JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RMHCI
Contact information
Practice address
1255 GOLFVIEW AVE, BARTOW, FL 33830-6736
(863) 519-0575
Mailing address
PO BOX 1559, BARTOW, FL 33831-1559
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
IMH16673
FL
Other
Enumeration date
09/21/2012
Last updated
04/10/2018
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