Marc N Jacobs, LICSW
Social Worker, Clinical in Medway, MA. Individual provider (NPI-1).
NPI number1669967410
StatusActive
Last updated in NPPESJun 25, 2018
Details
- NPI
- 1669967410
- Entity type
- Individual (NPI-1)
- Name
- Mr. Marc N Jacobs
- Credential
- LICSW
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 25, 2018
- Last updated
- Jun 25, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 104760 | MA | Yes |
Practice location
4 Lewis DrMedway, MA 02053-1033
Phone 508-533-6303
Mailing address
4 Lewis DrMedway, MA 02053-1033
Phone 508-533-6303
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