Individual
LAURA A. JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6906
Mailing address
1821 S STOUGHTON RD, MADISON, WI 53716-2257
(608) 260-6000
(608) 260-6906
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6268-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205331303
—
WI
Enumeration date
03/29/2018
Last updated
10/26/2021
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