Individual
EMMIE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
310 RED LAKE BLVD, THIEF RIVER FALLS, MN 56701-2133
(218) 416-1482
(218) 416-1483
Mailing address
3060 FRONTIER WAY S, FARGO, ND 58104-8909
(701) 232-2340
(701) 232-2330
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202761
MN
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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