| NPI | 1669004198 |
|---|---|
| Former Name | KATIE JACOBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 130643) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 17661) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16558) | |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2021-10-01 |