Individual
MS. EILEEN M. JETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
2230 N EDWARDS AVE, MT PLEASANT, TX 75455-2036
(903) 572-8551
(903) 575-2630
Mailing address
2230 N EDWARDS AVE, MT PLEASANT, TX 75455-2036
(903) 572-8551
(903) 575-2630
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103860
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126775
CHIP PROVIDER NUMBER
TX
01
—
8T0059
BCBS PROVIDER NUMBER
TX
Enumeration date
02/13/2007
Last updated
07/09/2007
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