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Individual

DR. ELLEN LEOTA JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., SLP

Contact information

Practice address
2704 2ND ST, BAKER CITY, OR 97814-2013
(541) 390-7376
Mailing address
2704 2ND ST, BAKER CITY, OR 97814-2013
(541) 390-7376

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12232
OR

Other

Enumeration date
03/30/2017
Last updated
03/30/2017
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