| Doctor Name: | CECILIA JACOBS |
| NPI Number: | 1356333678 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 5332 |
| Business Practice Address: | 2188 Gateway Dr Fairborn, OH - 453246356 |
| Business Phone Number: | 9373205859 |
| Business Fax Number: | 9374261349 |
| Mailing Address: | 2188 Gateway Dr, FAIRBORN |
| State: | OH |
| Postal Code: | 453246356 |
| Phone Number: | 9373205859 |
| Fax Number: | 9374261349 |
| NPI Enumeration Date: | 08/22/2005 |
| NPI Last Update Date: | 03/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 5332 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |