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1679231153
LISA A JACOBSON
FRUITA, CO
NPI
1679231153
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: CO 14129560)
Enumeration Date
2021-12-02
Last Update Date
2021-12-02
Business Address
LISA A JACOBSON
300 W OTTLEY AVE
FRUITA, CO 81521-2118
Phone number: 970-858-2147
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Mailing Address
LISA A JACOBSON
945 21 RD
FRUITA, CO 81521-9318
Phone number: 970-250-4432
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