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NPI Code Detail

MEDICARE: MS. DEBRA JACOBS OTR

MEDICARE: MS. DEBRA JACOBS OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist0526AZ

General Provider Information

NPI Number : 1295880201
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBRA JACOBS OTR
Provider Business Mailing Address
First Line : 5940 E PLACITA ALTA REPOSA
Second Line :
City : TUCSON
State : AZ
Zip : 85750-1058
Country : US
Telephone Number : 520-275-5044
Fax Number :
Provider Business Practice Location Address
First Line : 1010 E 10TH ST
Second Line :
City : TUCSON
State : AZ
Zip : 85719-5813
Country : US
Telephone Number : 520-275-5044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 09/26/2014

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