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Individual

CHRISTY M JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(469) 471-1895
Mailing address
4508 WOODBLUFF DR, MESQUITE, TX 75150-8284
(469) 471-1895

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117173
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
567896
VETERANS AFFAIRS
TX
Enumeration date
10/16/2020
Last updated
10/16/2020
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