Individual
MRS. JENNIFER WILSON PERIGORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT11277
Contact information
Practice address
2623 S SEACREST BLVD, BOYNTON BEACH, FL 33435-7501
(561) 737-7733
Mailing address
2623 S SEACREST BLVD, BOYNTON BEACH, FL 33435-7501
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
OT11277
FL
225X00000X
Occupational Therapist
Primary
OT11277
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889695000
—
FL
Enumeration date
11/29/2006
Last updated
05/14/2013
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