Randy W Jacobs, BS
Counselor, Mental Health in Wellsville, NY. Individual provider (NPI-1).
NPI number1720212871
StatusActive
Last updated in NPPESMay 5, 2009
Details
- NPI
- 1720212871
- Entity type
- Individual (NPI-1)
- Name
- Randy W Jacobs
- Credential
- BS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 5, 2009
- Last updated
- May 5, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
4220 State Route 417 WWellsville, NY 14895-9332
Phone 585-593-6300 · Fax 585-593-7071
Mailing address
4220 State Route 417 WWellsville, NY 14895-9332
Phone 585-593-6300 · Fax 585-593-7071
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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