Individual
MISS JESSICA LAURA WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
12901 N 63RD AVE, GLENDALE, AZ 85304-1701
(623) 412-4750
(623) 412-4755
Mailing address
6330 W THUNDERBIRD RD, GLENDALE, AZ 85306-4002
(623) 487-5192
(623) 487-5197
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3860
AZ
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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