Individual
MS. BETH ANNE JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
405 W MYRTLE ST, BOISE, ID 83702-7658
(208) 489-5880
Mailing address
2820 N PAULEY DR, BOISE, ID 83704-6034
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
01/06/2010
Last updated
06/24/2013
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