Individual
KAYLEE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 17TH AVE E, ALEXANDRIA, MN 56308-5273
(320) 762-6079
Mailing address
115 SUMAC DR, ALEXANDRIA, MN 56308-7916
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
106729
MN
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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