Provider Demographics
NPI:1497468342
Name:JACOBO, LORENA (LMSW)
Entity Type:Individual
Prefix:
First Name:LORENA
Middle Name:
Last Name:JACOBO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:LORENA
Other - Middle Name:
Other - Last Name:JACOBO RUBIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:907 OLD GLORY
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76502-6076
Mailing Address - Country:US
Mailing Address - Phone:706-483-2510
Mailing Address - Fax:
Practice Address - Street 1:907 OLD GLORY
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-6076
Practice Address - Country:US
Practice Address - Phone:706-483-2510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker