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Contact Information

JACKLYN R BOREN, COTA/L
43507 N IRONWOOD DR
SAN TAN VALLEY, AZ85140
 Phone: 480-757-2253
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for JACKLYN R BOREN · (Female)

NPI Number 1174233084
Status Active
Credentials COTA/L (Licensed Certified Occupational Therapy Assistant )
Entity Individual
Enumeration date 12/01/2022
Last updated 12/01/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # OTA-047153
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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