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:
Health care specialties
| Specialty | Code | License # | 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 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255458717 | NPPES |
| New Mexico | MEDICAID | J4176 |
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