Individual
JESSICA LAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1940 BONITA DR, APTOS, CA 95003-5524
(831) 684-1804
Mailing address
PO BOX 1005, WAITSFIELD, VT 05673-1005
(802) 730-7737
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
072.0074914
VT
225X00000X
Occupational Therapist
OT 8304
CA
Other
Enumeration date
03/18/2013
Last updated
12/29/2023
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