Individual
JESSICA MACKENZIE RICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7454 HOPE DRIVE, FORT WAYNE, IN 46815-5681
(260) 704-2106
Mailing address
7454 HOPE DR, FORT WAYNE, IN 46815-5681
(260) 704-2106
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001964A
IN
Other
Enumeration date
03/31/2011
Last updated
03/31/2011
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