Individual
BRIANNA JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2654 SW 39TH ST, OKLAHOMA CITY, OK 73119-3363
(405) 882-0042
Mailing address
2654 SW 39TH ST, OKLAHOMA CITY, OK 73119-3363
(405) 882-0042
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1648
OK
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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