Individual
MRS. JACQUELINE LYN ASHLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
11527 W PEORIA AVE, YOUNGTOWN, AZ 85363-1640
(623) 933-4683
(623) 972-4993
Mailing address
11527 W PEORIA AVE, YOUNGTOWN, AZ 85363-1640
(623) 933-4683
(623) 972-4993
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1549
AZ
Other
Enumeration date
11/26/2012
Last updated
11/26/2012
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