Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 638 | NC |
Y | 103TC0700X | Clinical Psychologist | 638 | NC |
NPI | 1003839036 |
---|---|
Provider Name | Dr. Marilyn Jacobson |
First Address | Chapel Hill, NC 27517-8549 |
Second Address | Chapel Hill, NC 27517-8549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 10/11/2008 |