Provider Demographics
NPI:1750351839
Name:MCGUIRE, JESSICA LEIGH (MOT)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:LEIGH
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LEIGH
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MOT
Mailing Address - Street 1:1125 NEW JERSEY AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1365
Mailing Address - Country:US
Mailing Address - Phone:202-904-5723
Mailing Address - Fax:
Practice Address - Street 1:131 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-1858
Practice Address - Country:US
Practice Address - Phone:412-303-9590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12294225X00000X
PAOC008972225X00000X
MD05056225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1635772OtherHIGHMARK
PA7651611OtherAETNA
396677Medicare ID - Type Unspecified