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Individual

CELINE DE JESUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTD, OTR/L

Contact information

Practice address
13385 W MCDOWELL RD, GOODYEAR, AZ 85395-2631
(623) 986-5110
Mailing address
2228 E CAMPBELL AVE APT 228, PHOENIX, AZ 85016-5550
(480) 689-0272

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-007874
AZ

Other

Enumeration date
07/18/2019
Last updated
12/10/2020
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