Individual
JESSICA SISA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 LATHAM DR, WARNER ROBINS, GA 31088-2146
(478) 887-3141
Mailing address
PO BOX 428, BONAIRE, GA 31005-0428
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007135
GA
Other
Enumeration date
05/16/2023
Last updated
05/16/2023
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