Individual
JESSICA A CARPENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(937) 245-2884
Mailing address
1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236-5638
(937) 245-2884
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008678
OH
225X00000X
Occupational Therapist
OT4199
TN
Other
Enumeration date
07/14/2010
Last updated
07/27/2020
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