Provider Demographics
NPI:1538316047
Name:JINKS, JESSICA PATRICK (LOTR)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:PATRICK
Last Name:JINKS
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:DENISE
Other - Last Name:PATRICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LOTR
Mailing Address - Street 1:1062 FERGUSON RD
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:LA
Mailing Address - Zip Code:71232-6526
Mailing Address - Country:US
Mailing Address - Phone:318-878-1879
Mailing Address - Fax:
Practice Address - Street 1:209 FAIR AVE
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:LA
Practice Address - Zip Code:71295-2119
Practice Address - Country:US
Practice Address - Phone:318-435-4366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAZ12351225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist