Individual
MS. JENNELL WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1745 E 24TH ST, JACKSONVILLE, FL 32206-2619
(904) 994-2795
Mailing address
1745 E 24TH ST, JACKSONVILLE, FL 32206-2619
(904) 994-2795
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
FL
224Z00000X
Occupational Therapy Assistant
—
FL
251E00000X
Home Health Agency
Primary
—
—
372600000X
Adult Companion
—
FL
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236990
HOMEMAKERS & COMPANION SVCS
FL
01
—
OTA17454
COTA
FL
Enumeration date
03/05/2022
Last updated
03/05/2022
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