Individual
JACKLYN LEANN FAABORG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1204 LINDEN ST, DALLAS CENTER, IA 50063-1052
(515) 992-3735
Mailing address
115 LAKE SHORE DR, DALLAS CENTER, IA 50063-2068
(319) 430-7384
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
088862
IA
Other
Enumeration date
05/01/2018
Last updated
04/21/2021
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