| NPI | 1407172315 |
|---|---|
| Former Name | JACLYN JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 119827) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2017-03-29 |