Individual
JILL L DEVALK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
200 S 9TH ST, DE PERE, WI 54115-1393
(920) 336-5680
Mailing address
200 S 9TH ST, DE PERE, WI 54115-1393
(920) 336-5680
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
803
WI
Other
Enumeration date
01/25/2007
Last updated
05/15/2008
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