Provider Demographics
NPI:1316726656
Name:WALKER, JESSICA ROSE (COTA/L)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ROSE
Last Name:WALKER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:MISS
Other - First Name:JESSICA
Other - Middle Name:ROSE
Other - Last Name:SAPIENZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13378 BEAVER DAM RD
Mailing Address - Street 2:
Mailing Address - City:ELLENDALE
Mailing Address - State:DE
Mailing Address - Zip Code:19941-3102
Mailing Address - Country:US
Mailing Address - Phone:302-245-3480
Mailing Address - Fax:
Practice Address - Street 1:7 FRONT ST
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:DE
Practice Address - Zip Code:19934-1121
Practice Address - Country:US
Practice Address - Phone:302-698-4800
Practice Address - Fax:302-697-3406
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU2-0012249224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant