Individual
JESSICA L WALSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1902 59TH ST W, BRADENTON, FL 34209-4602
(941) 761-1000
Mailing address
12610 DEEP BLUE PL, LAKEWOOD RANCH, FL 34211-4100
(941) 725-1813
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
09/29/2019
Last updated
09/29/2019
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