JALISSA NICOLE BLACK

VALDOSTA, GA
NPI1770346785
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225X00000X Occupational Therapist
(Licence: GA  OT009030)
Enumeration Date2024-02-01
Last Update Date2024-02-01
Business Address
JALISSA NICOLE BLACK OTD, OTR
3256 N VALDOSTA RD
VALDOSTA, GA 31602-1778
Phone number: 229-560-6944
Mailing Address
JALISSA NICOLE BLACK OTD, OTR
3256 N VALDOSTA RD
VALDOSTA, GA 31602-1778
Phone number: 229-560-6944