Provider Demographics
NPI:1902783517
Name:CHRISTIANSON, JESSICA LYNN (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LYNN
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8900 TRELLIS CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-8840
Mailing Address - Country:US
Mailing Address - Phone:727-364-9067
Mailing Address - Fax:
Practice Address - Street 1:280 MT HEBRON RD
Practice Address - Street 2:
Practice Address - City:ELMORE
Practice Address - State:AL
Practice Address - Zip Code:36025-1526
Practice Address - Country:US
Practice Address - Phone:334-567-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6781224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant