Kilee Jackson

Individual provider Active NPI Occupational Therapist · Given, WV

NPI 1144606609 · NPPES record last updated Aug 7, 2015

Key facts

NPI
1144606609
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
4551 (SC)
Practice address
246 Fayes Valley Rd
Given, WV 25245-8027
Phone
(304) 532-3975
NPI assigned
Aug 7, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4551SCMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4551 SC Yes

Addresses

Primary practice location

246 Fayes Valley Rd
Given, WV 25245-8027

Mailing address

246 Fayes Valley Rd
Given, WV 25245-8027
Phone (304) 532-3975

Other providers in Given, WV

All providers in Given, WV · Occupational Therapist in West Virginia

Sources for this page

Verify at the official NPI Registry.