Individual
JORDAN NICOLE REYNOLDS MAYFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
369 ISBELL LOOP, RUSSELLVILLE, AL 35654-7566
(256) 436-1834
Mailing address
369 ISBELL LOOP, RUSSELLVILLE, AL 35654
(256) 436-1834
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3068
AL
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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