Individual
JESSICA KOVALCHICK-REEVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
(704) 355-8674
Mailing address
1100 BLYTHE BLVD, CHARLOTTE, NC 28203-5814
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4783
NC
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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