Individual
JESSICA NICOLE SALLAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1344 CROSS CREEK CIR, TALLAHASSEE, FL 32301-3728
(850) 322-8709
Mailing address
1292 POND LN, GRAND RIDGE, FL 32442-4026
(850) 372-7188
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA18491
FL
Other
Enumeration date
11/10/2022
Last updated
11/10/2022
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