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Organization
MOBILE LYMPHEDEMA CLINIC LLC
Active
Organization
MOBILE LYMPHEDEMA CLINIC LLC
Active
Other names
Move Me Lymphatics-Mobile Lymphedema Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA COLLEEN BOOTHE MSOT, OTR/L, CLT (OWNER, CLINICIAN)
(850) 217-2186
Entity
Organization
Contact information
Practice address
804 PINE ALLEY ST, FORT WALTON BEACH, FL 32547-1216
(850) 803-6683
(888) 857-4412
Mailing address
804 PINE ALLEY ST, FORT WALTON BEACH, FL 32547-1216
(850) 803-6683
(888) 857-4412
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
—
—
225X00000X
Occupational Therapist
Primary
—
—
225XE0001X
Environmental Modification Occupational Therapist
—
—
225XE1200X
Ergonomics Occupational Therapist
—
—
225XG0600X
Gerontology Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Enumeration date
09/04/2025
Last updated
02/18/2026
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