Individual
ELISHEVA CHANA JACOBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
56 POMONA RD, SUFFERN, NY 10901-1800
(845) 362-5555
Mailing address
56 POMONA RD, SUFFERN, NY 10901-1800
(917) 497-1877
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
011810-1
NY
225X00000X
Occupational Therapist
46TR00318700
NJ
Other
Enumeration date
12/01/2008
Last updated
06/29/2020
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