Individual
MRS. JAYME MICHELE BOURGEOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
140 NORMANDY RD, LOUISBURG, NC 27549-9032
(919) 495-2543
Mailing address
9932 SWEET BASIL DR, WAKE FOREST, NC 27587-4127
(732) 770-5706
(919) 882-9502
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5022
NC
Other
Enumeration date
10/11/2019
Last updated
10/11/2019
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