Individual
JACQUELINE GRACE BRYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
549 GLEN RIDGE DR S, BRIDGEWATER, NJ 08807-1613
(908) 745-1017
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
12491
MA
Other
Enumeration date
11/03/2017
Last updated
11/03/2017
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