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Individual

JACI WATSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT

Contact information

Practice address
505 JACKS CANYON RD, SEDONA, AZ 86351-7856
(928) 284-1000
Mailing address
PO BOX 124, KEYSTONE, SD 57751-0124

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
144A
SD
224Z00000X
Occupational Therapy Assistant
5302
AZ
225XG0600X
Gerontology Occupational Therapist
Primary
5472
AZ

Other

Enumeration date
11/27/2012
Last updated
05/15/2014
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