MEDICARE: MRS. JESSICA H YOUNT OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	2686	SC

General Provider Information

NPI Number	:	1932351863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA H YOUNT OTR/L

Provider Business Mailing Address
First Line	:	1271 COTTAGE DR
Second Line	:
City	:	SUMMERTON
State	:	SC
Zip	:	29148-7008
Country	:	US
Telephone Number	:	803-460-4655
Fax Number	:	803-488-0031

Provider Business Practice Location Address
First Line	:	116 MAIN ST
Second Line	:
City	:	SUMMERTON
State	:	SC
Zip	:	29148-6904
Country	:	US
Telephone Number	:	803-460-4655
Fax Number	:	803-488-0031

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2008
Last Update Date	:	07/31/2025

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