Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jalissa Nicole Black, OTD, OTR

Individual provider Occupational Therapist · NPI 1770346785

Jalissa Nicole Black, OTD, OTR is an Occupational Therapist in Valdosta, Georgia. Licensed in Georgia. Registered with an NPI since 2024.

Licensed in
GA
In the registry since
2024
What do these letters mean?
OTD — Doctor of Occupational Therapy
The doctoral degree in occupational therapy.
OTR — Occupational Therapist, Registered
A nationally registered occupational therapist.

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Practice location Address checks out

3256 N Valdosta Rd
Valdosta, GA 31602-1778
Phone: (229) 560-6944
Fax: (888) 450-0379
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT009030 (GA)

Record details

NPI number1770346785
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTD , OTR
Sole proprietorNo
NPI enumeratedFebruary 1, 2024
Last updated in NPPESFebruary 1, 2024
Certification dateFebruary 1, 2024

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