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General NPI Number Information
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NPI Number | 1598468290
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Entity Type | Individual
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Provider Name | JACOB TOLER LPC
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Gender | Male
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 820 S FRIENDSWOOD DR STE 213
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-4591
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Country | US
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Telephone | 281-819-0191
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Fax |
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Provider Business Mailing Address
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Address Line | 811 MURPHY LN
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City | FRIENDSWOOD
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State | TX
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Zip | 77546-4731
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Country | US
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Telephone | 832-858-5253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 83071
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License Number State | TX
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