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General NPI Number Information
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NPI Number | 1073432746
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Entity Type | Individual
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Provider Name | PHARRAH N JEAN-LOUIS CNA,COTA/L
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Gender | Female
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 2261 SW PLYMOUTH ST
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34953-2380
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Country | US
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Telephone | 772-626-6903
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Fax |
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Provider Business Mailing Address
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Address Line | 2216 CONWAY CIR
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City | SUMMERVILLE
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State | SC
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Zip | 29486-8111
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Country | US
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Telephone | 772-626-6903
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA19469
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License Number State | FL
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