Provider Demographics
NPI:1356990535
Name:HINKLE, JESSE MICHELLE (OCCUPATION THERAPIST)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:MICHELLE
Last Name:HINKLE
Suffix:
Gender:F
Credentials:OCCUPATION THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 LINCOLN AVE STE 209
Mailing Address - Street 2:
Mailing Address - City:CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2451
Mailing Address - Country:US
Mailing Address - Phone:724-483-2159
Mailing Address - Fax:724-489-4758
Practice Address - Street 1:325 MCCLELLANDTOWN RD
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-5096
Practice Address - Country:US
Practice Address - Phone:724-439-6294
Practice Address - Fax:724-439-8947
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015833225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist