Individual
MRS. JESSICA MOUNTJOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
6808 GRAYSON DR, BENTON, AR 72019-9763
(501) 860-8056
Mailing address
6808 GRAYSON DR, BENTON, AR 72019-9763
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0T-A1131
AR
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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