Provider Demographics
NPI:1750128559
Name:JACOBS, RACHEL IRENE (OTD)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:IRENE
Last Name:JACOBS
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2222 10TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1344
Mailing Address - Country:US
Mailing Address - Phone:660-346-1281
Mailing Address - Fax:
Practice Address - Street 1:5 E CHERRY ST
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-8800
Practice Address - Country:US
Practice Address - Phone:319-626-2257
Practice Address - Fax:319-359-4015
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA127280225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics