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Individual

MS. JACKOLYN L APODACA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOTR/L

Contact information

Practice address
1101 LOPEZ RD SW, ALBUQUERQUE, NM 87105-3954
(505) 877-7060
Mailing address
2808 CHARLESTON ST NE, ALBUQUERQUE, NM 87110-2702
(505) 870-7537

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
NM

Other

Enumeration date
11/30/2017
Last updated
11/30/2017
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