Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | ||
N | 103T00000X | Psychologist | ||
Y | 102L00000X | Psychologist | 5762 | NC |
Y | 103T00000X | Psychologist | 5762 | NC |
N | 103G00000X | Clinical Psychologist | 5762 | NC |
N | 103TC0700X | Clinical Psychologist | 5762 | NC |
N | 103TH0100X | Health Service | ||
N | 103TH0100X | Health Service | 5762 | NC |
NPI | 1417500414 |
---|---|
Provider Name | Dr. Lauren Jacobs |
First Address | Salisbury, NC 28144-2515 |
Second Address | Salisbury, NC 28144-2515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2019 |
Last Update Date | 26/01/2021 |