Individual
JODY J VICTORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1300 C ST, SPRINGFIELD, OR 97477-4850
(208) 703-9661
Mailing address
1300 C ST, SPRINGFIELD, OR 97477-4850
(208) 703-9661
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
234481
OR
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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