Provider Information for 1538348354
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ALETHA SHA JACOBS M.S.
Sex: Female
NPI: 1538348354
Last Updated: 2023-06-14
Certification Date: 2023-06-14
Certification Date: 2023-06-14
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1538348354 | ||||||||
| Enumeration Date | 2007-10-29 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 69004 ALEXANDRIA, LA 71306-9004 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 2903 STRAIGHT ELM FRESNO, TX 77545-8163 United States Phone: 832-236-1565 | Fax: | ||||||||
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