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General NPI Number Information
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NPI Number | 1467824631
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Entity Type | Individual
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Provider Name | JESSICA WARD
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Gender | Female
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 2301 OLD BAINBRIDGE RD APARTMENT 1406
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City | TALLAHASSEE
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State | FL
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Zip | 32303-3853
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Country | US
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Telephone | 850-556-2697
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Fax |
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Provider Business Mailing Address
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Address Line | 2301 OLD BAINBRIDGE RD APARTMENT 1406
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City | TALLAHASSEE
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State | FL
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Zip | 32303-3853
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Country | US
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Telephone | 850-556-2697
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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 | OTA12907
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License Number State | FL
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