Provider Demographics
NPI:1932948239
Name:JACOBS, JULIA (BA)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 SW 89TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6312
Mailing Address - Country:US
Mailing Address - Phone:405-676-5313
Mailing Address - Fax:405-237-3440
Practice Address - Street 1:1414 SW 89TH ST STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6312
Practice Address - Country:US
Practice Address - Phone:405-676-5313
Practice Address - Fax:405-237-3440
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management