Individual
JESSICA DAWN SEVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8820 HORIZON BLVD NE, ALBUQUERQUE, NM 87113-1689
(505) 998-1551
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA3939
NM
Other
Enumeration date
05/11/2019
Last updated
05/11/2019
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