Individual
SHANNON L JACOBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 783-1414
(419) 784-2799
Mailing address
1400 E 2ND ST, DEFIANCE, OH 43512-2440
(419) 784-1414
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007374
OH
Other
Enumeration date
09/17/2009
Last updated
08/17/2015
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