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1275293441
JENNIFER COSTLEY
SOUTHAVEN, MS
NPI
1275293441
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
Enumeration Date
2021-12-29
Last Update Date
2021-12-29
Business Address
JENNIFER COSTLEY COTA
3807
SOUTHAVEN, MS 38672
Phone number: 714-345-3268
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Mailing Address
JENNIFER COSTLEY COTA
3807 COBBLEWOOD DR
SOUTHAVEN, MS 38672-6557
Phone number:
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