Individual
MRS. JACLYN ANN FOWLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
1120 VIA CALLEJON STE B, SAN CLEMENTE, CA 92673-6264
(949) 878-0625
Mailing address
1120 VIA CALLEJON STE B, SAN CLEMENTE, CA 92673-6264
(949) 878-0625
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10345
CA
Other
Enumeration date
07/17/2009
Last updated
07/17/2009
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