| Doctor Name: | DR. JAMES LELAND JACOBS |
| NPI Number: | 1588713978 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | PS600 |
| Business Practice Address: | 123 Mudget Hill Rd Vassalboro, ME - 049894305 |
| Business Phone Number: | 2074454756 |
| Business Fax Number: | |
| Mailing Address: | 123 Mudget Hill Rd, VASSALBORO |
| State: | ME |
| Postal Code: | 049894305 |
| Phone Number: | 2074454756 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TA0400X |
| License Number: | PS600 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |