Provider Demographics
NPI:1255876744
Name:SANCHEZ, JAMILLE SEGARRA (OTR/L)
Entity type:Individual
Prefix:
First Name:JAMILLE
Middle Name:SEGARRA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JAMILLE
Other - Middle Name:MARIE
Other - Last Name:SEGARRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1038 SHORTHILL LN
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-0170
Mailing Address - Country:US
Mailing Address - Phone:305-300-9166
Mailing Address - Fax:
Practice Address - Street 1:1038 SHORTHILL LN
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-0170
Practice Address - Country:US
Practice Address - Phone:305-300-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-20
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10310225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics