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Individual

JESSICA HORAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1000 EDDY STREET, PROVIDENCE, RI 02905
(401) 481-0823
Mailing address
121 MEADOWLARK DR, SEEKONK, MA 02771-2713
(508) 272-4980

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00168-G
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2092
EI NHPRC
RI
01
292177
EI BCROSS
RI
01
412296
EI BCHIP
RI
01
6400144
EI UNITED
RI
05
ES01788
RI
Enumeration date
07/19/2011
Last updated
05/30/2014
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