Individual
JILLIAN JARRELL MALCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LOTR
Contact information
Practice address
302 N SPRING DR, WOODWORTH, LA 71485-9739
(318) 792-8101
Mailing address
302 N SPRING DR, WOODWORTH, LA 71485-9739
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.200293
LA
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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