Individual
MRS. JORDAN WILSON HARBOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
4052 CRENSHAW RD, MILLINGTON, TN 38053-7510
(662) 471-1051
Mailing address
4052 CRENSHAW RD, MILLINGTON, TN 38053-7510
(662) 471-1051
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5772
TN
Other
Enumeration date
02/06/2018
Last updated
02/06/2018
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