MATTHEW ELMO JACOBSON

MORONI, UT
NPI1952672735
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date2012-01-25
Last Update Date2012-01-25
Business Address
MATTHEW ELMO JACOBSON
21360 N 1450 E
MORONI, UT 84646-0461
Phone number: 435-445-5200
Mailing Address
MATTHEW ELMO JACOBSON
PO BOX 461
MORONI, UT 84646-0461
Phone number: 435-445-5200
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