Individual
JESSICA WALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2498 DAYTON XENIA RD, BEAVERCREEK, OH 45434-7169
(937) 427-1919
Mailing address
2498 DAYTON XENIA RD, BEAVERCREEK, OH 45434-7169
(937) 427-1919
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007338
OH
Other
Enumeration date
04/05/2011
Last updated
04/05/2011
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