Provider Demographics
NPI:1225921034
Name:HART, JESSICA (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3013 RIDGELAKE DR APT 218
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-4945
Mailing Address - Country:US
Mailing Address - Phone:504-451-3688
Mailing Address - Fax:
Practice Address - Street 1:3409 DIVISION ST STE 202
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4611
Practice Address - Country:US
Practice Address - Phone:504-603-6044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-30
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA342305225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist