Individual
MICHELLE JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3018 AVENUE R, BROOKLYN, NY 11229-2621
(718) 339-3086
Mailing address
3018 AVENUE R, BROOKLYN, NY 11229-2621
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
013815-1
NY
Other
Enumeration date
06/07/2009
Last updated
06/07/2009
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