Individual
JESSICA LEANN BURLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
251 SUNSET PL, GUIN, AL 35563-2239
(205) 468-3331
Mailing address
5122 NEWBURG RD, HALEYVILLE, AL 35565-6617
(205) 269-9911
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3087
AL
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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