Jacobs, Mary W.

Jacobs, Mary W. is an sole proprietor health care provider with primary practice located at 31 White Oak Rd , Waban MA 02468-1322. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Jacobs, Mary W. can be contacted via phone (617) 969-2356.

Contact Information

Primary practice address
31 White Oak Rd Waban MA 02468-1322
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X #106248 Massachusetts
Behavioral Health & Social Service Providers / Clinical 1041C0700X 106248 Massachusetts

Profile Details

NPI number 1871772632
LBN Legal business name Jacobs, Mary W.
Credentials LICSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 29th, 2007
Last updated Oct 29th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871772632 NPPES
Massachusetts Other JA P20772 MEDICARE B

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