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1710255336
ALAN R JACOB
PROVO, UT
NPI
1710255336
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: UT 6740945-6009)
Enumeration Date
2011-12-09
Last Update Date
2011-12-09
Business Address
-- ALAN R JACOB L.P.C.
1355 N UNIVERSITY AVE SUITE 200
PROVO, UT 84604-2721
Phone number: 801-221-0223
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Mailing Address
-- ALAN R JACOB L.P.C.
1355 N UNIVERSITY AVE SUITE 200
PROVO, UT 84604-2721
Phone number: 801-221-0223
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