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1063611853
LIESL JADE JACOBS
MORAINE, OH
NPI
1063611853
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: OH 35.097603)
Enumeration Date
2007-07-12
Last Update Date
2015-05-07
Business Address
-- LIESL JADE JACOBS MD
5350 LAMME RD
MORAINE, OH 45439-3215
Phone number: 937-534-4651
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Mailing Address
-- LIESL JADE JACOBS MD
1 PRESTIGE PL SUITE 550
MIAMISBURG, OH 45342-3794
Phone number: 937-752-2310
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