JENNIFER LYNN WALLACE

WENTZVILLE, MO
NPI1972264273
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: MO  2010026736)
Enumeration Date2022-01-07
Last Update Date2022-01-07
Business Address
JENNIFER LYNN WALLACE COTA/L
4009 RIVERDELL DR
WENTZVILLE, MO 63385-4775
Phone number: 636-734-9985
Mailing Address
JENNIFER LYNN WALLACE COTA/L
4009 RIVERDELL DR
WENTZVILLE, MO 63385-4775
Phone number: 636-734-9985