Individual
JESSICA HAIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1650 PHILLIPS RD, TALLAHASSEE, FL 32308-5304
(850) 942-9868
Mailing address
1805A FOREST LN, BAINBRIDGE, GA 39817-8113
(229) 205-2772
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
17148
FL
Other
Enumeration date
05/16/2019
Last updated
05/16/2019
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