Provider Demographics
NPI:1235830951
Name:JACOBS, BRIA DORIS
Entity Type:Individual
Prefix:
First Name:BRIA
Middle Name:DORIS
Last Name:JACOBS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 WILMINGTON PL SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-6160
Mailing Address - Country:US
Mailing Address - Phone:347-265-0711
Mailing Address - Fax:
Practice Address - Street 1:148 WILMINGTON PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-6160
Practice Address - Country:US
Practice Address - Phone:347-265-0711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator