| Leah Jacob Licsw Llc | |
|
100 W Franklin Ave Ste 301 Minneapolis MN 55404-2446 | |
| (612) 805-4206 | |
| Not Available |
| Full Name | Leah Jacob Licsw Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 W Franklin Ave Ste 301, Minneapolis, Minnesota |
| Authorized Official Name and Position | Leah Jacob (PRESIDENT) |
| Authorized Official Contact | 6128054206 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leah Jacob Licsw Llc 100 W Franklin Ave Ste 301 Minneapolis MN 55404-2446 Ph: (612) 805-4206 | Leah Jacob Licsw Llc 100 W Franklin Ave Ste 301 Minneapolis MN 55404-2446 Ph: (612) 805-4206 |
| NPI Number | 1477193944 |
|---|---|
| Provider Enumeration Date | 01/13/2020 |
| Last Update Date | 01/13/2020 |
| Certification Date | 01/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477193944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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