Provider Demographics
NPI:1528654910
Name:JAKYMA, CHRISTINE
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:JAKYMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27112 LAUREL LN
Mailing Address - Street 2:
Mailing Address - City:OLMSTED TWP
Mailing Address - State:OH
Mailing Address - Zip Code:44138-3543
Mailing Address - Country:US
Mailing Address - Phone:440-420-3801
Mailing Address - Fax:
Practice Address - Street 1:27112 LAUREL LN
Practice Address - Street 2:
Practice Address - City:OLMSTED TWP
Practice Address - State:OH
Practice Address - Zip Code:44138-3543
Practice Address - Country:US
Practice Address - Phone:440-420-3801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-19
Last Update Date:2020-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist