Provider Demographics
NPI:1093476475
Name:JAKUBOWSKE, MARILIN R (SOCIAL WORKER)
Entity Type:Individual
Prefix:
First Name:MARILIN
Middle Name:R
Last Name:JAKUBOWSKE
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5424 RUFE SNOW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-6685
Mailing Address - Country:US
Mailing Address - Phone:254-289-2285
Mailing Address - Fax:682-593-3936
Practice Address - Street 1:5424 RUFE SNOW DR STE 200
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-6685
Practice Address - Country:US
Practice Address - Phone:254-289-2285
Practice Address - Fax:682-593-3936
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX60460101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health