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General NPI Number Information
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NPI Number | 1811516859
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Entity Type | Individual
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Provider Name | GABRIELA C JACOB PSY.D
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Gender | Female
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Dates
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Enumeration Date | 04/09/2020
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 5034 BELL DR SE
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City | SMYRNA
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State | GA
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Zip | 30080-2637
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Country | US
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Telephone | 239-877-6758
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6014
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City | MARIETTA
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State | GA
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Zip | 30065-0014
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Country | US
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Telephone | 239-877-6758
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | CA
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