Individual
MARIAH JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3150 SAINT CHARLES ST, JASPER, IN 47546-1858
(812) 504-2264
Mailing address
24 S 1000 E, CELESTINE, IN 47521-9659
(812) 827-3027
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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