Most Relevant Information
Provider Data
| NPI Number: | 1003571431 |
| Provider Name: | JACLYN OLDENBURG MS, OT |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 5201011646 |
Most Important Dates
| Enumeration Date: | 11/01/2021 |
| Last Updated: | 07/10/2023 |
Provider Practice Location
16760 LINCOLN ST
GRAND HAVEN
MI
494178864
Practice Location Phone/Fax
| Phone: | 6169353300 |
| Fax: | 6169353333 |
Provider Mailing Location
1311 MAMARONECK AVE STE 140
WHITE PLAINS
NY
106055224
Provider Mailing Phone/Fax
| Phone: | 9142944050 |
| Fax: | 6317608306 |