Individual
JESSICA LEUTHIPHONH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 ANDERSON RD STE C, GREENVILLE, SC 29611-7651
(864) 295-9890
Mailing address
619 COWPENS CLIFTON RD, SPARTANBURG, SC 29307-3324
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4945
SC
Other
Enumeration date
12/02/2019
Last updated
12/02/2019
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