Provider Demographics
NPI:1063003424
Name:ENGLER, JACOB A (QMHP)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:A
Last Name:ENGLER
Suffix:
Gender:M
Credentials:QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8013 OSAGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2476
Mailing Address - Country:US
Mailing Address - Phone:734-673-0845
Mailing Address - Fax:
Practice Address - Street 1:8013 OSAGE AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2476
Practice Address - Country:US
Practice Address - Phone:734-673-0845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator