MEDICARE: CHRISTINE JAKYMA

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
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1528654910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE JAKYMA

Provider Business Mailing Address
First Line	:	27112 LAUREL LN
Second Line	:
City	:	OLMSTED TWP
State	:	OH
Zip	:	44138-3543
Country	:	US
Telephone Number	:	440-420-3801
Fax Number	:

Provider Business Practice Location Address
First Line	:	27112 LAUREL LN
Second Line	:
City	:	OLMSTED TWP
State	:	OH
Zip	:	44138-3543
Country	:	US
Telephone Number	:	440-420-3801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2020
Last Update Date	:	12/19/2020

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Directions to “ CHRISTINE JAKYMA ” Practice Location

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