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Individual

JEANNE MIREILLE JACOBI-MARINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LOTR

Contact information

Practice address
202 BETZ PL, METAIRIE, LA 70005-4106
(504) 250-9553
(504) 895-4516
Mailing address
202 BETZ PL, METAIRIE, LA 70005-4106
(504) 250-9553
(504) 895-4516

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z12290
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1302686
LA
01
9440442
PHCS
LA
Enumeration date
03/09/2007
Last updated
07/08/2007
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