Jessica Anderson
Individual provider Active NPI Occupational Therapist · Booneville, KY
NPI 1699239236 · NPPES record last updated Jan 28, 2019
Key facts
- NPI
- 1699239236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- BOTOCT00195835 (KY)
- Practice address
- 20 County Barn Rd
Booneville, KY 41314-6500 - Phone
- (606) 593-6302
- NPI assigned
- Jan 28, 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 |
|---|---|---|---|
| BOTOCT00195835 | KY | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist |
225X00000X | BOTOCT00195835 | KY | Yes |
Addresses
Primary practice location
20 County Barn Rd
Booneville, KY 41314-6500
Mailing address
105 Popular LN
Manchester, KY 40962-6000
Other providers in Booneville, KY
- Addiction Recovery Care LLC
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- Angel Renee Birch
- Brittany Bobrowski
- Booneville Family Dentistry
- Kevin Brashear
- Melody Brewer
All providers in Booneville, KY · Occupational Therapist in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 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.