Provider Demographics
NPI:1407497886
Name:JACOBSON, SHARI SZUCS
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:SZUCS
Last Name:JACOBSON
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 1:2502 PACKARD ST UNIT 3106
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-6850
Mailing Address - Country:US
Mailing Address - Phone:734-355-1339
Mailing Address - Fax:
Practice Address - Street 1:2502 PACKARD ST UNIT 3106
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-6850
Practice Address - Country:US
Practice Address - Phone:734-355-1339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program