Individual
JESSICA ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 COUNTY BARN RD, BOONEVILLE, KY 41314-6500
(606) 593-6302
Mailing address
105 POPULAR LN, MANCHESTER, KY 40962-6000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
BOTOCT00195835
KY
Other
Enumeration date
01/28/2019
Last updated
01/28/2019
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