Individual
MS. THERESA MICHELLE JAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
495 BIRCHWOOD LN, DELTONA, FL 32738-8921
(386) 574-7392
Mailing address
495 BIRCHWOOD LN, DELTONA, FL 32738-8921
(386) 574-7392
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OT 2740
FL
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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