Individual
JENNIFER WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
690 E WARNER RD STE 105, GILBERT, AZ 85296-3055
(480) 820-6366
Mailing address
1681 W MUSKET WAY, CHANDLER, AZ 85286-8406
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6042
AZ
Other
Enumeration date
12/17/2014
Last updated
12/17/2014
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