Individual
JESSICA LEE BACKHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2240
(919) 731-2805
Mailing address
1700 WAYNE MEMORIAL DR, GOLDSBORO, NC 27534-2240
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13011
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13011
NCBOT
NC
01
—
6258
DORA
CO
Enumeration date
04/14/2021
Last updated
11/07/2023
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