Provider Demographics
NPI:1811156433
Name:MCCOTTER, JESSICA TURNER (COTA/L)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:TURNER
Last Name:MCCOTTER
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 1:7518 DUNBAR RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-9626
Mailing Address - Country:US
Mailing Address - Phone:910-256-3733
Mailing Address - Fax:
Practice Address - Street 1:221 SUMMER REST RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-4135
Practice Address - Country:US
Practice Address - Phone:910-256-3733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3513224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant