Provider Demographics
NPI:1609082536
Name:JOBIN, JEREMY VINCENT (OTR)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:VINCENT
Last Name:JOBIN
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 TWINKLING SKY AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-6900
Mailing Address - Country:US
Mailing Address - Phone:702-469-8653
Mailing Address - Fax:
Practice Address - Street 1:2625 E SAINT LOUIS AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104-4200
Practice Address - Country:US
Practice Address - Phone:702-799-1500
Practice Address - Fax:702-799-1502
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0733225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist