Individual
JENNIE SUE MCGILLICUDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
Mailing address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT9565
CA
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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