Individual
JENNIFER JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 FRIANT ST, GRAND HAVEN, MI 49417-2311
(616) 842-4120
Mailing address
18463 IROQUOIS DR, SPRING LAKE, MI 49456-9128
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101002086
MI
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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