Divine, Jessica A

Divine, Jessica A is an individual health care provider with primary practice located at 1800 Penn St Ste 12, Melbourne FL 32901-2643. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. Divine, Jessica A can be contacted via phone (321) 768-6800.

Contact Information

Primary practice address
1800 Penn St Ste 12 Melbourne FL 32901-2643
Phone: (321) 768-6800
Fax: (321) 768-6858
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X OTA11802 Florida

Profile Details

NPI number 1154605186
LBN Legal business name Divine, Jessica A
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2011
Last updated Oct 10th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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