Individual
MARIELISE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1751 SARNO RD STE 5, MELBOURNE, FL 32935-4909
(321) 255-7779
(321) 255-7774
Mailing address
1751 SARNO RD STE 5, MELBOURNE, FL 32935-4909
(321) 255-7779
(321) 255-7774
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT16287
FL
Other
Enumeration date
06/18/2014
Last updated
06/18/2014
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