Individual
CARLY MORGAN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
250 E 40TH ST, NEW YORK, NY 10016-1721
(516) 375-6814
Mailing address
14 VALLEY LN W, VALLEY STREAM, NY 11581-3633
(516) 791-1278
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
015818-1
NY
Other
Enumeration date
11/02/2010
Last updated
11/17/2010
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