Individual
JENNIFER WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4091 EASTCHESTER DR, BRYAN, TX 77802-4735
(979) 776-2826
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
107782
TX
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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