Individual
VANESSA GALE BACCARAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4120 KURTH ST S, SALEM, OR 97302-2724
(503) 570-3665
(503) 570-9155
Mailing address
4120 KURTH ST S, SALEM, OR 97302-2724
(503) 570-3665
(503) 570-9155
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2431
OR
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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