Individual
JENNIFER PACILEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1772 CARLEE DR, HERNANDO, MS 38632-8844
(662) 469-2906
Mailing address
1772 CARLEE DR, HERNANDO, MS 38632-8844
(662) 469-2906
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT3580
MS
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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