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1699037671
CHAD E JACOBS
WICHITA, KS
NPI
1699037671
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: KS 506)
Enumeration Date
2012-06-14
Last Update Date
2012-06-14
Business Address
CHAD E JACOBS LAC
3540 W DOUGLAS AVE
WICHITA, KS 67203-5455
Phone number: 316-943-2051
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Mailing Address
CHAD E JACOBS LAC
900 E LAHARPE ST
KIRKSVILLE, MO 63501-4520
Phone number: 660-665-1962
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