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Individual

JESSIKA MAE VIOLA WHEELER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L, CLT

Contact information

Practice address
480 HIGHWAY 96 E STE 120, VADNAIS HEIGHTS, MN 55127-2557
(848) 665-1482
Mailing address
108 OWENS ST S, STILLWATER, MN 55082-5637
(206) 948-0551

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
105445
MN

Other

Enumeration date
10/09/2017
Last updated
11/10/2022
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