Individual
JESSICA DAWN ELAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 ANSON ST, SALEM, IN 47167-1982
(812) 820-0081
Mailing address
7330 E MOUNT EDEN RD, SCOTTSBURG, IN 47170-5315
(812) 820-0081
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002237
IN
Other
Enumeration date
08/29/2012
Last updated
07/31/2020
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