Individual
JACQUELINE REESE WALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, OTR/L, CHT
Contact information
Practice address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Mailing address
4500 SAN PABLO RD S, JACKSONVILLE, FL 32224-1865
(904) 953-2000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT11381
FL
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT 11381
LICENSE #
FL
Enumeration date
08/20/2006
Last updated
10/09/2024
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