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Individual

JESSICA R DEINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
3001 SPRING FOREST RD, RALEIGH, NC 27616-2815
(913) 904-2241
Mailing address
13405 W 56TH PL, SHAWNEE, KS 66216-4634
(913) 904-2241

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-02587
KS
225X00000X
Occupational Therapist
2009013185
MO

Other

Enumeration date
03/27/2010
Last updated
10/03/2016
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