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Contact Information

JESSE WILCOCK, OTR/L
218 W WHITE MOUNTAIN BLVD
SUITE A & B
LAKESIDE, AZ85929-7013
 Phone: 928-367-5779
 Fax: 928-367-5778
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Mental Health

225XM0800X 67 Occupational Therapist in Private Practice
 

Pediatrics

225XP0200X 67 Occupational Therapist in Private Practice
 

Physical Rehabilitation

225XP0019X 67 Occupational Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for JESSE WILCOCK · (Male)

NPI # 1528487840
Status Active
Credentials OTR/L (Occupational Therapist, Registered, Licensed)
Entity Individual
Enumeration date 04/15/2014
Last updated 04/15/2014 - About 12 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 5751
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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