MEDICARE: JENNIFER ROWE

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	0119006074	VA

General Provider Information

NPI Number	:	1689068991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER ROWE

Provider Business Mailing Address
First Line	:	929 HILLSIDE AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-1907
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	929 HILLSIDE AVE
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23503-1907
Country	:	US
Telephone Number	:	781-315-7059
Fax Number	:

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

Provider Enumeration Date	:	03/25/2015
Last Update Date	:	03/25/2015

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Directions to “ JENNIFER ROWE ” Practice Location

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