Individual
JESSICA A JENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-4645
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9463
NC
225XP0200X
Pediatric Occupational Therapist
OT 14657
FL
Other
Enumeration date
05/09/2011
Last updated
11/04/2014
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