Individual
JACKLYN RACHELLE BOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
43507 N IRONWOOD DR, SAN TAN VALLEY, AZ 85140
(480) 757-2253
Mailing address
6737 E VILLEROY CIR, MESA, AZ 85215-7734
(480) 735-4132
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-047153
AZ
Other
Enumeration date
12/01/2022
Last updated
12/01/2022
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