Individual
MS. NANCY ANN JAKUBIEC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2961 SAINT ANTHONY DR, GREEN BAY, WI 54311-5860
(920) 468-0861
(920) 468-3087
Mailing address
2961 ST ANTHONY DRIVE, GREEN BAY, WI 54311
(920) 468-0861
(920) 468-3087
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
949-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40737200
—
WI
Enumeration date
04/09/2008
Last updated
04/09/2008
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