Individual
JACLYN CARBONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
101 MONROE ST, PETALUMA, CA 94954-2328
(707) 763-4109
Mailing address
116 BISHOP CT, NOVATO, CA 94945-3401
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT12787
CA
Other
Enumeration date
08/13/2018
Last updated
08/13/2018
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