Organization Name: | LINDA M JACOBUS A PROFESSIONAL CORPORATION |
NPI Number: | 1396098620 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LINDA M JACOBUS (PRESIDENT) |
Mailing Address: | 273 Main St Yarmouth |
State: | ME US |
Postal Code: | 040966753 |
Phone Number: | 7144042878 |
Fax Number: | |
NPI Enumeration Date: | 10/24/2012 |
NPI Last Update Date: | 10/24/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MF3924 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |