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Individual

JILL DESMOND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.O.T.A./L

Contact information

Practice address
113 RYANS GATE RD, POMARIA, SC 29126-8663
(352) 302-4320
Mailing address
113 RYANS GATE RD, POMARIA, SC 29126-8663
(352) 302-4320

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
11359
FL
224Z00000X
Occupational Therapy Assistant
Primary
3219
SC

Other

Enumeration date
10/16/2013
Last updated
10/16/2013
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