Individual
JASMINE AZUCENA FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
350 E LA CANADA BLVD, AVONDALE, AZ 85323-1643
(623) 932-2282
Mailing address
10350 W MCDOWELL RD APT 3123, AVONDALE, AZ 85392-4827
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0313-P
AZ
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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