Most Relevant Information
Provider Data
| NPI Number: | 1003482100 |
| Provider Name: | GISELLE AMARIS JACOB MS |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/28/2021 |
| Last Updated: | 05/28/2021 |
Provider Practice Location
1244 CLAIRMONT RD STE 204
DECATUR
GA
300301263
Practice Location Phone/Fax
| Phone: | 4048186535 |
| Fax: |
Provider Mailing Location
275 13TH ST NE APT 107
ATLANTA
GA
303093697
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |