Individual
JESSICA WALCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7831
(928) 537-6537
(928) 537-7969
Mailing address
2200 E SHOW LOW LAKE RD, SHOW LOW, AZ 85901-7831
(928) 537-6537
(928) 537-7969
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2859
AZ
Other
Enumeration date
12/13/2011
Last updated
07/24/2012
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