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1770346785
JALISSA NICOLE BLACK
VALDOSTA, GA
NPI
1770346785
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: GA OT009030)
Enumeration Date
2024-02-01
Last Update Date
2024-02-01
Business Address
JALISSA NICOLE BLACK OTD, OTR
3256 N VALDOSTA RD
VALDOSTA, GA 31602-1778
Phone number: 229-560-6944
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Mailing Address
JALISSA NICOLE BLACK OTD, OTR
3256 N VALDOSTA RD
VALDOSTA, GA 31602-1778
Phone number: 229-560-6944
Copy
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