| NPI | 1487266888 |
|---|---|
| Doing Business As | KIAN JACOBS LCSW |
| Entity Type | Organization |
| Authorized Contact | KIAN FAY JACOBS Owner 860-817-3175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |