Individual
MRS. JESSICA NICOLE WHITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
330 TAZEWELL ST, WYTHEVILLE, VA 24382-2316
(276) 228-5411
Mailing address
569 KENNEDY DR, POUNDING MILL, VA 24637-3587
(276) 963-0997
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1472
WV
Other
Enumeration date
06/07/2007
Last updated
07/08/2007
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