Individual
TANYA JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT ABT
Contact information
Practice address
1621 PAULINE CIR, MUNDELEIN, IL 60060-4128
(847) 877-1795
Mailing address
1621 PAULINE CIR, MUNDELEIN, IL 60060-4128
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
227010146
IL
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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