Jayme Michele Bourgeois, COTA/L
Individual provider Active NPI Occupational Therapy Assistant · Louisburg, NC
NPI 1386286235 · NPPES record last updated Oct 11, 2019
Key facts
- NPI
- 1386286235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 5022 (NC)
- Practice address
- 140 Normandy Rd
Louisburg, NC 27549-9032 - Phone
- (919) 495-2543
- NPI assigned
- Oct 11, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5022 | NC | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 5022 | NC | Yes |
Addresses
Primary practice location
140 Normandy Rd
Louisburg, NC 27549-9032
Mailing address
9932 Sweet Basil Dr
Wake Forest, NC 27587-4127
Phone (732) 770-5706
Other providers in Louisburg, NC
- Sheila Joan Bishop
- Brittney Tashawn Black
- Warren Allen Blackburn
- Tracey Jean Blain
- Tiana Blake
- Whitney Gail Bowman
- Liliana Breton
- Crystal Smith Bright
- Emily Kate Minser Briskie
- Britthaven, Inc.
All providers in Louisburg, NC · Occupational Therapy Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.