Individual
JESSICA SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3250 WINKLER AVE, FORT MYERS, FL 33916-9414
(239) 939-4993
Mailing address
19228 PALMDALE CT, PORT CHARLOTTE, FL 33948-9619
(716) 785-5707
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
18191
FL
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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