Jessica Alvillar

Individual provider Active NPI Occupational Therapy Assistant · Apache Junction, AZ

NPI 1629634779 · NPPES record last updated May 14, 2019

Key facts

NPI
1629634779
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
5650 (AZ)
Practice address
2012 W Southern Ave
Apache Junction, AZ 85120-7305
Phone
(480) 983-0770
NPI assigned
May 14, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5650AZMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 5650 AZ Yes

Addresses

Primary practice location

2012 W Southern Ave
Apache Junction, AZ 85120-7305

Mailing address

2313 E Carol Ave
Mesa, AZ 85204-2911
Phone (480) 201-3914

Other providers in Apache Junction, AZ

All providers in Apache Junction, AZ · Occupational Therapy Assistant in Arizona

Sources for this page

Verify at the official NPI Registry.