Individual
MS. JERELYN SUSAN DENKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA L
Contact information
Practice address
103 S ERFIE DR, PINEBLUFF, NC 28373-8296
(910) 528-4465
Mailing address
103 S ERFIE DR, PINEBLUFF, NC 28373-8296
(910) 528-4465
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1124
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124
OTA L
NC
Enumeration date
06/14/2007
Last updated
07/08/2007
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