Individual
JESSICA JOYNER GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
25112 HIGHWAY 15, UNION, MS 39365-8580
(601) 774-8300
Mailing address
25112 HIGHWAY 15, UNION, MS 39365-8580
(601) 774-8300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-3336
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OTA-3336
—
MS
Enumeration date
03/12/2021
Last updated
03/12/2021
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