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Individual

JACLYN PHIPPS WEBBER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OCCUPATIONAL THERAPI

Contact information

Practice address
4015 2ND AVE STE B, SUMMERVILLE, SC 29486-7882
(803) 929-7408
(888) 711-0441
Mailing address
PO BOX 168, CRYSTAL SPRINGS, MS 39059-0168
(803) 929-7408
(850) 588-9641

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
4394
SC
225X00000X
Occupational Therapist
OT16627
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
013553100
FL
Enumeration date
10/09/2014
Last updated
12/13/2019
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