Individual
SAMUEL COLE JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
43279 SCHOENHERR RD, STERLING HEIGHTS, MI 48313-1957
(313) 278-4601
Mailing address
6861 RICHMOND DR, TROY, MI 48098-1594
(248) 895-3797
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
Z3WA3DJZ
MI
Other
Enumeration date
04/09/2024
Last updated
04/09/2024
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