Provider Demographics
NPI:1801683248
Name:JACOBSON, ADINA
Entity type:Individual
Prefix:
First Name:ADINA
Middle Name:
Last Name:JACOBSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 FREEMAN ST APT 244
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3568
Mailing Address - Country:US
Mailing Address - Phone:888-828-4114
Mailing Address - Fax:888-828-4114
Practice Address - Street 1:68 HARVARD ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7991
Practice Address - Country:US
Practice Address - Phone:888-828-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASLP101275235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist