Individual
MRS. CHELSEA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CTRS
Contact information
Practice address
14090 EDGEWOOD ST, LIVONIA, MI 48154-5334
(810) 623-5649
Mailing address
14090 EDGEWOOD ST, LIVONIA, MI 48154-5334
(810) 623-5649
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
68500
MI
Other
Enumeration date
12/05/2016
Last updated
12/05/2016
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