Individual
ELLEN M JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2323 DEL PRADO BLVD, #7, CAPE CORAL, FL 33990-4640
(239) 822-6249
Mailing address
2323 DEL PRADO BLVD, #7, CAPE CORAL, FL 33990-4640
(239) 822-6249
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
31001927A
IN
225X00000X
Occupational Therapist
4443-026
WI
225X00000X
Occupational Therapist
Primary
OT8946
FL
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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