Individual
LISA CATHLEEN JACOBUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
718 SMYTH RD, MANCHESTER, NH 03104-7007
(603) 624-4366
Mailing address
718 SMYTH RD, MANCHESTER, NH 03104-7007
(603) 624-4366
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1593
NH
Other
Enumeration date
12/05/2006
Last updated
08/24/2011
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