Jennifer Lynn Wallace, COTA/L
NPI #1972264273 in Wentzville, Missouri
Provider Information
- NPI Number
- 1972264273
- Entity Type
- Individual
- Name
- Jennifer Lynn Wallace, COTA/L
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Occupational Therapy Assistant
- Credential
- COTA/L
- Enumeration Date
- Jan 7, 2022
- Last Updated
- Jan 7, 2022
Practice Location
- Address
- 4009 RIVERDELL DR
- City
- Wentzville
- State
- Missouri
- ZIP Code
- 63385-4775
- Phone
- (636) 734-9985
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapy Assistant |
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