| Jalissa Nicole Black, OTD, OTR | |
|
3256 N Valdosta Rd, Valdosta, GA 31602-1778 | |
| (229) 560-6944 | |
| (888) 450-0379 |
| Full Name | Jalissa Nicole Black |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 3256 N Valdosta Rd, Valdosta, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770346785 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT009030 (Georgia) | Primary |
| Provider Name | Thrive Physical Therapy And Wellness Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1760128672 PECOS PAC ID: 8123401379 Enrollment ID: O20220820000049 |
| Mailing Address | Practice Location Address |
|---|---|
| Jalissa Nicole Black, OTD, OTR 3256 N Valdosta Rd, Valdosta, GA 31602-1778 Ph: (229) 560-6944 | Jalissa Nicole Black, OTD, OTR 3256 N Valdosta Rd, Valdosta, GA 31602-1778 Ph: (229) 560-6944 |
Mrs. Taylor Elizabeth George, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 W Moore St, Valdosta, GA 31602 Phone: 229-253-8500 Fax: 229-253-8522 | |
Mrs. Emily Sandoval, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 202 W Park Ave, Valdosta, GA 31602 Phone: 229-253-8500 Fax: 229-253-8522 | |
Insight Therapy Services, Llc Occupational Therapist Medicare: Medicare Enrolled Practice Location: 2108 N Patterson St, Valdosta, GA 31602 Phone: 229-244-3000 Fax: 229-244-1934 | |
Cheryl Randolph, OT Occupational Therapist Medicare: Medicare Enrolled Practice Location: 111 Woodrow Wilson Dr Ste C, Valdosta, GA 31602 Phone: 229-262-4075 Fax: 229-262-4076 | |
Morgan Brooke Boruff, OTR/L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 809 N Patterson St, Valdosta, GA 31601 Phone: 229-469-6932 Fax: 229-469-6933 | |
Ms. Melissa Yvette Hoffman, OTR L Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 3021 Kensington Ln, Valdosta, GA 31602 Phone: 229-242-6795 Fax: 229-219-2280 | |
Mrs. Deborah Mcnair Mcturk, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1062 Ridge Rd, Valdosta, GA 31605 Phone: 229-245-9428 Fax: 229-253-8904 |