Individual
HEAVEN LEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
224 SPRING CREEK RD, OKLAHOMA CITY, OK 73117-1703
(405) 822-1508
Mailing address
224 SPRING CREEK RD, OKLAHOMA CITY, OK 73117-1703
(405) 822-1508
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1832
OK
Other
Enumeration date
01/21/2021
Last updated
01/25/2021
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