Provider Demographics
NPI:1588040026
Name:JACOBS, MARLA (MS, RDN)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:JACOBS
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:572 SHRADER ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:PA
Mailing Address - Zip Code:15144-1062
Mailing Address - Country:US
Mailing Address - Phone:724-274-4213
Mailing Address - Fax:
Practice Address - Street 1:960 PENN AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3818
Practice Address - Country:US
Practice Address - Phone:412-288-2130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered