| Jacobsons Ladder, Llc | |
|
4445 Corporation Ln Ste 153 Virginia Beach VA 23462-3262 | |
| (757) 213-6995 | |
| Not Available |
| Full Name | Jacobsons Ladder, Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4445 Corporation Ln, Virginia Beach, Virginia |
| Authorized Official Name and Position | Ronald S Jacobson (OWNER) |
| Authorized Official Contact | 7572136995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacobsons Ladder, Llc 4445 Corporation Ln Ste 153 Virginia Beach VA 23462-3262 Ph: (757) 213-6995 | Jacobsons Ladder, Llc 4445 Corporation Ln Ste 153 Virginia Beach VA 23462-3262 Ph: (757) 213-6995 |
| NPI Number | 1730469925 |
|---|---|
| Provider Enumeration Date | 08/19/2011 |
| Last Update Date | 08/19/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730469925 | NPI | - | NPPES |
| 7704143 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810000305 (Virginia) | Primary |
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