=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982350641
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JESSICA MAY OCCUPATIONAL THERAPY, L.L.C
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2022
-----------------------------------------------------
Last Update Date | 11/06/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 305 MAIN STREET
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71418-5603
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-502-6633
-----------------------------------------------------
Fax | 318-404-1520
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1683
-----------------------------------------------------
City | COLUMBIA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 71418-1683
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 318-502-6633
-----------------------------------------------------
Fax | 318-404-1520
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/OCCUPATIONAL THERAPIST
-----------------------------------------------------
Name | JESSICA MAY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 318-331-7997
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------