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General NPI Number Information
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NPI Number | 1922921311
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Entity Type | Individual
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Provider Name | CAROLINE JESSEE
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Gender | Female
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 26208 LEE HWY
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City | ABINGDON
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State | VA
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Zip | 24211-7504
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Country | US
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Telephone | 276-258-5537
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Fax |
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Provider Business Mailing Address
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Address Line | 1360 RIVERBEND DR APT 105
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City | KINGSPORT
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State | TN
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Zip | 37664-4079
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Country | US
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Telephone | 276-206-7048
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119011527
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License Number State | VA
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