Individual
MS. JILL MAREE CAVAZOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
30 W 22ND ST, HOLLAND, MI 49423-4703
(616) 990-4760
Mailing address
30 W 22ND ST, HOLLAND, MI 49423-4703
(616) 990-4760
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007658
MI
Other
Enumeration date
07/08/2013
Last updated
07/08/2013
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