Individual
MISS JESSICA DESIREE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
2300 COLEMAN RD, ANNISTON, AL 36207
(256) 831-5730
Mailing address
2300 COLEMAN RD, ANNISTON, AL 36207
(256) 831-5730
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3713
AL
Other
Enumeration date
05/15/2017
Last updated
05/15/2017
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