NPI 1659819076

Haley Jacob

Practitioner Prevention Professional La Crosse, WI

Practice location

Address: 1725 State St 126 Mitchell Hall, La Crosse, WI 54601-3742
Phone: (216) 978-1173
Mailing address: 18442 High Pkwy, Rocky River, OH 44116-2829

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 1901-39 (WI)

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Registry record

NPI: 1659819076
Entity type: Individual
Sex (as registered): Female
NPI issued: 6 Feb 2017
Record last updated: 6 Feb 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.