Individual
MRS. JENNIFER DIANE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
380 CANYONVIEW DR, FARMINGTON, NM 87401-8630
(505) 324-0542
(505) 324-0542
Mailing address
6426 BENT TREE CIR., FARMINGTON, NM 87402
(505) 324-8353
(505) 324-8353
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1649
NM
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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