Individual
JAEMEY T MATHERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
11224 E RALEIGH AVE, MESA, AZ 85212-4061
(480) 528-9978
Mailing address
11224 E RALEIGH AVE, MESA, AZ 85212-4061
(480) 528-9978
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OTH-009522
AZ
225XP0200X
Pediatric Occupational Therapist
Primary
OTH-009522
AZ
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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