Individual
BETSY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 FRANKLIN TPKE, RIDGEWOOD, NJ 07450-1932
(201) 447-1900
Mailing address
167 CHRISTIE ST, LEONIA, NJ 07605-1901
(201) 983-3026
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00348700
NJ
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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