Individual
JERRIE CHANDELL VALES AQUINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
16428 E KINGSTREE BLVD, FOUNTAIN HILLS, AZ 85268-5440
(480) 837-4565
Mailing address
PO BOX 5762, HAGATNA, GU 96932
(671) 971-0843
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056010312
IL
225X00000X
Occupational Therapist
22
GU
225X00000X
Occupational Therapist
Primary
6565
AZ
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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