Individual
JAZZ TAYLOR WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
13385 W MCDOWELL RD, GOODYEAR, AZ 85395-2631
(623) 986-5110
Mailing address
4222 S 186TH AVE, GOODYEAR, AZ 85338-7974
(801) 649-7025
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
009039
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
36052364
DRIVER LICENSE
AZ
Enumeration date
01/24/2023
Last updated
01/24/2023
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