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General NPI Number Information
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NPI Number | 1407662497
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Entity Type | Individual
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Provider Name | JORDYN MICHELE WOODS OTA/L
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Gender | Female
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 632 S WILMOT RD
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City | TUCSON
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State | AZ
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Zip | 85711-4000
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Country | US
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Telephone | 520-993-2879
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Fax | 479-439-7966
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Provider Business Mailing Address
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Address Line | 4765 W MARS ST
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City | TUCSON
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State | AZ
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Zip | 85741-1843
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Country | US
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Telephone | 520-904-7718
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 005694
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License Number State | AZ
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