Individual
MRS. CARRIE RENEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBA, OTRL, C/NDT
Contact information
Practice address
11930 WHITMORE LAKE RD., SUITE I-M, WHITMORE LAKE, MI 48189
(734) 449-4649
(734) 449-4669
Mailing address
11930 WHITMORE LAKE RD., SUITE I-M, WHITMORE LAKE, MI 48189
(734) 449-4649
(734) 449-4669
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
5201004063
MI
Other
Enumeration date
12/08/2006
Last updated
02/18/2013
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