Individual
JENNIFER MCGOVERN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
900 W DOLPHIN ST, SILER CITY, NC 27344-3711
(919) 663-3431
Mailing address
107 RIBBON LANE, APT R, CARY, NC 27518
(850) 556-2707
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9151
NC
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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