| NPI | 1902485626 |
|---|---|
| Former Name | STACEY EVELYN JAKUBOWSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MA 12969) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CT 48.005444) |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2024-05-23 |