Individual
KATHLEEN LEONTINE JESSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, IBCLC
Contact information
Practice address
11309 DUSTY TRAIL CT, ROANOKE, TX 76262-1927
(940) 208-9198
Mailing address
PO BOX 1192, ARGYLE, TX 76226-1192
(940) 208-9198
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
L302117
—
225X00000X
Occupational Therapist
122278
TX
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
Primary
122278
TX
225XP0200X
Pediatric Occupational Therapist
122278
TX
Other
Enumeration date
04/01/2009
Last updated
06/22/2023
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