Individual
JOCELYN NACKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3560 DELAWARE ST STE 311, BEAUMONT, TX 77706-3060
(409) 299-4638
Mailing address
13 EAGLE RIDGE DR, NEW HARTFORD, NY 13413-2260
(315) 534-9746
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
021862
NY
225X00000X
Occupational Therapist
11336
NC
225X00000X
Occupational Therapist
118934
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021862
STATE LICENSE
NY
01
—
11336
STATE LICENSE
NC
01
—
118934
STATE LICENSE
TX
01
—
389927
NBCOT
—
Enumeration date
04/02/2018
Last updated
04/02/2018
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