Patricia Jacobs

NPI #1063064384 in Meridian, Idaho

Provider Information

NPI Number: 1063064384
Entity Type: Individual
Name: Patricia Jacobs
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Developmental Therapist
Enumeration Date: Jul 16, 2019
Last Updated: Jul 16, 2019

Practice Location

Address: 3800 W PERUGIA ST APT V108
City: Meridian
State: Idaho
ZIP Code: 83642-4966
Phone: (208) 964-4532

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Developmental Therapist	222Q00000X	Primary

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