Jacobs, Ellen

Jacobs, Ellen is an individual health care provider with primary practice located at 55 Camerada Loop , Santa Fe NM 87508-8232. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Jacobs, Ellen can be contacted via phone (505) 466-2506.

Contact Information

Primary practice address
55 Camerada Loop Santa Fe NM 87508-8232
Phone: (505) 466-2506
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 265 New Mexico

Profile Details

NPI number 1255458717
LBN Legal business name Jacobs, Ellen
Credentials Occupational Therapist (OT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 22nd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255458717 NPPES
New Mexico MEDICAID J4176

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