MEDICARE: JENNIFER A CROSS MA, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	0170	NV

General Provider Information

NPI Number	:	1528358140
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER A CROSS MA, OTR/L

Provider Business Mailing Address
First Line	:	645 N ARLINGTON AVE
Second Line	:	SUITE 350
City	:	RENO
State	:	NV
Zip	:	89503-4460
Country	:	US
Telephone Number	:	775-770-3104
Fax Number	:	775-770-3692

Provider Business Practice Location Address
First Line	:	645 N ARLINGTON AVE
Second Line	:	SUITE 350
City	:	RENO
State	:	NV
Zip	:	89503-4460
Country	:	US
Telephone Number	:	775-770-3104
Fax Number	:	775-770-3692

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/15/2011
Last Update Date	:	04/15/2011

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Directions to “ JENNIFER A CROSS MA, OTR/L” Practice Location

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