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Individual

MS. JILL MARIE DELZEITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
1649 SPY RUN AVE, FORT WAYNE, IN 46805-4032
(260) 422-8520
Mailing address
1820 PAPERMILL XING, FORT WAYNE, IN 46825-5919
(260) 484-1931

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001032A
IN

Other

Enumeration date
05/15/2007
Last updated
07/08/2007
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