Individual
DIANNE JEZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
16 LONDONDERRY RD, WINDHAM, NH 03087-1651
(603) 434-8015
Mailing address
16 LONDONDERRY RD, WINDHAM, NH 03087-1651
(603) 434-8015
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
1551M
NH
225X00000X
Occupational Therapist
Primary
1303
NH
225X00000X
Occupational Therapist
3854
MA
Other
Enumeration date
12/14/2016
Last updated
12/14/2016
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