Individual
JODIE RAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8124 N 57TH DR, GLENDALE, AZ 85302-5904
(623) 826-3997
Mailing address
8124 N 57TH DR, GLENDALE, AZ 85302-5904
(623) 826-3997
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2887
AZ
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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