Individual
MRS. SHANNON LEIGH JERNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
125 SOUTHERN JUNCTION BLVD, POOLER, GA 31322-2214
(912) 348-1910
Mailing address
125 SOUTHERN JUNCTION BLVD, POOLER, GA 31322-2214
(912) 348-1910
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0003298
CO
225X00000X
Occupational Therapist
Primary
006678
GA
225X00000X
Occupational Therapist
7335
NC
Other
Enumeration date
10/14/2009
Last updated
12/15/2024
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