| NPI | 1417243767 |
|---|---|
| Former Name | LYNN JACOBS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: MI 6301014502) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6301014502) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: MI 6301014502) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2016-09-21 |