Individual
JILL WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.O.T.R/L
Contact information
Practice address
205 E STATE ST, REDLANDS, CA 92373-5232
(909) 793-1078
(909) 335-7330
Mailing address
34889 GRAPE AVE, YUCAIPA, CA 92399-6012
(909) 809-0129
(909) 793-1078
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
7786
CA
Other
Enumeration date
11/26/2013
Last updated
11/26/2013
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