Provider Demographics
NPI:1568696649
Name:JACOBS, PERRI PALMER (EDD)
Entity Type:Individual
Prefix:DR
First Name:PERRI
Middle Name:PALMER
Last Name:JACOBS
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6220 MADISON DR
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-2682
Mailing Address - Country:US
Mailing Address - Phone:251-978-2790
Mailing Address - Fax:188-860-1494
Practice Address - Street 1:6220 MADISON DR
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-2682
Practice Address - Country:US
Practice Address - Phone:251-978-2790
Practice Address - Fax:188-860-1494
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-05
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL541101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor