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General NPI Number Information
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NPI Number | 1013522093
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Entity Type | Organization
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Legal Business Name | RUTH L. JACOBSON, MS, LMFT, LLC
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 10 N MAIN ST STE 315
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1901
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Country | US
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Telephone | 860-604-3101
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Fax | 860-658-6002
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Provider Business Mailing Address
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Address Line | 17 MERRYWOOD
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City | SIMSBURY
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State | CT
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Zip | 06070-2613
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Country | US
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Telephone | 860-604-3101
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Fax | 860-658-6002
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Authorized Official
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Title or Position | MARRIAGE & FAMILY THERAPIST
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Name | MRS. RUTH L JACOBSON
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Credential | LMFT
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Telephone | 860-604-3101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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