Individual
JENNIFER COLLEEN WHITAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT R L
Contact information
Practice address
11800 WEST THOMPSON RANCH, EL MIRAGE, AZ 85335
(623) 523-8487
Mailing address
8556 W SUNNYSLOPE LN, PEORIA, AZ 85345-5362
(623) 523-8487
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3202
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
889313
—
AZ
Enumeration date
02/06/2007
Last updated
07/08/2007
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