Healthcare Provider Details

I. General information

NPI: 1215567821
Provider Name (Legal Business Name): COURTNEY JESSICA PICKNEY OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2020
Last Update Date: 01/22/2020
Certification Date: 01/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 S HULL ST
MONTGOMERY AL
36104-4610
US

IV. Provider business mailing address

3518 CLAIBORNE CIR
MONTGOMERY AL
36116-8800
US

V. Phone/Fax

Practice location:
  • Phone: 334-834-2920
  • Fax:
Mailing address:
  • Phone: 334-320-5431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: