| Doctor Name: | CINDY RENEE JACOBS |
| NPI Number: | 1114103223 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LCP 817 |
| Business Practice Address: | 2101 Us Highway 50 Byp Dodge City, KS - 678012230 |
| Business Phone Number: | 6202278566 |
| Business Fax Number: | 6202255824 |
| Mailing Address: | 2101 Us Highway 50 Byp, DODGE CITY |
| State: | KS |
| Postal Code: | 678012230 |
| Phone Number: | 6202278566 |
| Fax Number: | 6202255824 |
| NPI Enumeration Date: | 01/18/2008 |
| NPI Last Update Date: | 01/18/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LCP 817 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |