Individual
JENNIFER C DEBOURGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
193 SAM LISENBY RD, OZARK, AL 36360-3048
(334) 445-6336
(334) 445-6363
Mailing address
193 SAM LISENBY RD, OZARK, AL 36360-3048
(334) 445-6336
(334) 445-6363
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056008492
IL
225X00000X
Occupational Therapist
Primary
3252
AL
Other
Enumeration date
01/21/2010
Last updated
05/31/2011
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