Individual
JESSICA VINESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
9225 UNIVERSITY BLVD, STE E2C, NORTH CHARLESTON, SC 29406-9149
(843) 569-4546
(843) 569-4535
Mailing address
9225 UNIVERSITY BLVD, STE E2C, NORTH CHARLESTON, SC 29406-9149
(843) 569-4546
(843) 569-4535
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4191
SC
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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