| NPI | 1972610459 |
|---|---|
| Former Name | JACLYN M ROADRUCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: WA OT00003236) |
| Additional Taxonomies | 174400000X Specialist (Licence: AK 1805) |
| 174400000X Specialist (Licence: WA OT00003236) | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2021-11-15 |