Healthcare Provider Details

I. General information

NPI: 1114863867
Provider Name (Legal Business Name): MORGAN RANAE JACOBSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 8TH AVE NW
ABERDEEN SD
57401-2762
US

IV. Provider business mailing address

1209 KETTERING DR
ABERDEEN SD
57401-3243
US

V. Phone/Fax

Practice location:
  • Phone: 605-725-2828
  • Fax:
Mailing address:
  • Phone: 952-693-1196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: