Individual
MRS. JILL MARIE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
16355 W POST DR, SURPRISE, AZ 85388-2174
(480) 392-5986
Mailing address
16355 W POST DR, SURPRISE, AZ 85388-2174
(480) 392-5986
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTA-006347
COTA/L
AZ
Enumeration date
04/05/2021
Last updated
04/05/2021
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