Provider Demographics
NPI:1427815943
Name:BATTAGLIA, JESSICA ANGELA
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANGELA
Last Name:BATTAGLIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 KNOB HILL DR
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27863-8243
Mailing Address - Country:US
Mailing Address - Phone:973-919-9092
Mailing Address - Fax:
Practice Address - Street 1:106 KNOB HILL DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:NC
Practice Address - Zip Code:27863-8243
Practice Address - Country:US
Practice Address - Phone:973-919-9092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-01
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120368225X00000X
NC16686225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist