Provider Demographics
NPI:1336437383
Name:WHITE, JESSICA (OT)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01534-1073
Mailing Address - Country:US
Mailing Address - Phone:401-480-9384
Mailing Address - Fax:
Practice Address - Street 1:110 HAVERHILL RD
Practice Address - Street 2:SUITE 401
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-2123
Practice Address - Country:US
Practice Address - Phone:978-834-7125
Practice Address - Fax:978-834-7225
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT01007225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist