| NPI | 1417411851 |
|---|---|
| Other Name | JESSICA RENE ROAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: TX 212654) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: AR OT-A883) |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2019-01-30 |