Provider Demographics
NPI:1427214295
Name:ROLAND, JESSICA H (MHS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:H
Last Name:ROLAND
Suffix:
Gender:F
Credentials:MHS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 COCHIN TRCE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-8245
Mailing Address - Country:US
Mailing Address - Phone:803-341-5133
Mailing Address - Fax:
Practice Address - Street 1:200 WELLMORE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9157
Practice Address - Country:US
Practice Address - Phone:803-500-1194
Practice Address - Fax:803-674-0500
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3422225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist