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Individual

JACQUELINE A BODDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, OT

Contact information

Practice address
6404 SUSSEX ST, PORTAGE, MI 49024-2653
(269) 271-3585
Mailing address
6404 SUSSEX ST, PORTAGE, MI 49024-2653
(269) 271-3585

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008144
MI

Other

Enumeration date
01/28/2013
Last updated
01/28/2026
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