Individual
JESSICA LEA WATTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3615 W MAIN ST, SALEM, VA 24153-1961
(540) 380-5500
Mailing address
3615 W MAIN ST, SALEM, VA 24153-1961
(540) 380-5500
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000841
VA
Other
Enumeration date
07/01/2014
Last updated
07/01/2014
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