Individual
MRS. JESSICA KRISTEEN WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT, OTR/L
Contact information
Practice address
101 NW 1ST ST, 114, EVANSVILLE, IN 47708-1259
(812) 402-0444
(812) 402-0449
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 473-5822
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31005314A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31005314A
OCCUPATIONAL THERAPY LICENSE
IN
05
—
7100405700
—
KY
Enumeration date
06/26/2011
Last updated
12/02/2016
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