Daisy Jacobo, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Noel, MO

NPI 1912465972 · NPPES record last updated Mar 8, 2019

Key facts

NPI
1912465972
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
Practice address
171 Huntley LN
Noel, MO 64854-9383
Phone
(479) 866-5062
NPI assigned
Mar 8, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X AR Yes

Addresses

Primary practice location

171 Huntley LN
Noel, MO 64854-9383

Mailing address

171 Huntley LN
Noel, MO 64854-9383
Phone (479) 866-5062

Other providers in Noel, MO

All providers in Noel, MO · Occupational Therapy Assistant in Missouri

Sources for this page

Verify at the official NPI Registry.