Provider Demographics
NPI:1992773469
Name:JACOBS, JEANNE M (CCC/SLP)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:M
Last Name:JACOBS
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 ALPHA DR STE A109
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2906
Mailing Address - Country:US
Mailing Address - Phone:412-913-6572
Mailing Address - Fax:833-523-1775
Practice Address - Street 1:246 ALPHA DR STE A109
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2906
Practice Address - Country:US
Practice Address - Phone:412-913-6572
Practice Address - Fax:833-523-1775
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004560L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA396676Medicare Oscar/Certification