Individual
MRS. JORDYN RAE WEIDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3150 N WINDING BROOK RD, FLAGSTAFF, AZ 86001-0972
(928) 774-7106
Mailing address
4008 PIPIT PL, FLAGSTAFF, AZ 86004-4070
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7434
AZ
Other
Enumeration date
04/26/2018
Last updated
04/26/2018
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