MRS. Brenda Lavonne Jacob, MS, CCDC III, LAT is an addiction (substance use disorder) counselor in Gillette, WY. MRS. Brenda Lavonne Jacob, MS, CCDC III, LAT NPI is 1780812214. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
The provider's business location address is:
113 S GILLETTE AVE
GILLETTE, WY
ZIP 82716-740
Phone: (307) 685-6982
Fax: (307) 685-8054
The enumeration date for this NPI number is 6/23/2009 and was last updated on 6/23/2009.