Individual
JACLYN OLDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OT
Contact information
Practice address
16760 LINCOLN ST, GRAND HAVEN, MI 49417-8864
(616) 935-3300
(616) 935-3333
Mailing address
1311 MAMARONECK AVE STE 140, WHITE PLAINS, NY 10605-5224
(914) 294-4050
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201011646
MI
Other
Enumeration date
11/01/2021
Last updated
07/10/2023
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