Individual
JESSICA WALTERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
10237 W ENCANTO BLVD, AVONDALE, AZ 85392-4702
(623) 772-2670
Mailing address
6121 W MARCONI AVE, GLENDALE, AZ 85306-2306
(262) 354-2732
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-008117
AZ
Other
Enumeration date
01/06/2021
Last updated
03/03/2025
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