Individual
JACQUELINE HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
22420 N 180TH DR, SURPRISE, AZ 85387-1563
(602) 432-8638
Mailing address
22420 N 180TH DR, SURPRISE, AZ 85387-1563
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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