LAVONNE JACOBSON

SHAWANO, WI
NPI1104017953
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2007-08-07
Last Update Date2014-01-15
Business Address
-- LAVONNE JACOBSON CSAC
504 LAKELAND RD
SHAWANO, WI 54166-3836
Phone number: 715-526-5547
Mailing Address
-- LAVONNE JACOBSON CSAC
504 LAKELAND RD
SHAWANO, WI 54166-3836
Phone number: 715-526-5547