| K.a. Jacobson, Ph.d., Pllc | |
|
5101 Olson Memorial Hwy Suite 4003 Golden Valley MN 55422-5149 | |
| (763) 595-7294 | |
| (763) 595-7293 |
| Full Name | K.a. Jacobson, Ph.d., Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5101 Olson Memorial Hwy, Golden Valley, Minnesota |
| Authorized Official Name and Position | Kathleen A. Jacobson (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 7635957294 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| K.a. Jacobson, Ph.d., Pllc 5101 Olson Memorial Hwy Suite 4003 Golden Valley MN 55422-5149 Ph: (763) 595-7294 | K.a. Jacobson, Ph.d., Pllc 5101 Olson Memorial Hwy Suite 4003 Golden Valley MN 55422-5149 Ph: (763) 595-7294 |
| NPI Number | 1154363414 |
|---|---|
| Provider Enumeration Date | 06/12/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154363414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LP0158 (Minnesota) | Primary |
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