Individual
JESSA NORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2625 E 250S, HUNTINGBURG, IN 47542-9543
(812) 309-1983
Mailing address
2625 E 250S, HUNTINGBURG, IN 47542-9543
(812) 309-1983
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
172406
KY
225X00000X
Occupational Therapist
Primary
31006307A
IN
225X00000X
Occupational Therapist
OTP-OT-LIC-7676
MT
Other
Enumeration date
01/14/2018
Last updated
12/02/2020
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