Individual
JENNIFER DESLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005828
GA
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
15112
NC
225XP0200X
Pediatric Occupational Therapist
15112
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141022A
—
GA
Enumeration date
01/08/2014
Last updated
09/27/2023
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