Individual
JEANETTE WELLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
209 W 9TH ST, AUSTIN, TX 78701-2320
(512) 389-7537
Mailing address
2910 E 5TH ST, AUSTIN, TX 78702-4817
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
1219
NV
224Z00000X
Occupational Therapy Assistant
Primary
212121
TX
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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