Individual
MS. MICHELLE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
105 GLENWAY ST, DORCHESTER, MA 02121-4109
(617) 265-6140
Mailing address
105 GLENWAY ST, DORCHESTER, MA 02121-4109
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3299
MA
Other
Enumeration date
06/15/2009
Last updated
06/15/2009
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