Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | 62024 | TX |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 62024 | TX |
Y | 101YM0800X | Mental Health Counselor | 62024 | TX |
N | 101YP2500X | Professional Counselor | 62024 | TX |
N | 101YS0200X | School Counselor | 62024 | TX |
N | 103G00000X | Clinical Psychologist | 62024 | TX |
N | 103TC0700X | Clinical Psychologist | 62024 | TX |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 62024 | TX |
N | 103TA0700X | Adult Development & Aging Psychologist | 62024 | TX |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 62024 | TX |
N | 103TC1900X | Counseling Psychologist | 62024 | TX |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 62024 | TX |
N | 103TF0000X | Family Psychologist | 62024 | TX |
N | 103TH0100X | Health Service | 62024 | TX |
N | 103TP2701X | Group Psychotherapist | 62024 | TX |
NPI | 1083888507 |
---|---|
Provider Name | Prof. Aaron Benjamin Jacobs |
First Address | Dallas, TX 75229-6324 |
Second Address | Dallas, TX 75229-6324 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2008 |
Last Update Date | 16/04/2008 |