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NPI Code Detail

MEDICARE: JENNIFER HEWITT

MEDICARE: JENNIFER HEWITT
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
1252Y00000XEarly Intervention Provider AgencyOTT.200290LA

General Provider Information

NPI Number : 1851304257
Entity Type Code : Organization
Provider Name (Legal Business Name) : JENNIFER HEWITT
Provider Business Mailing Address
First Line : 49352 FEDELE RD
Second Line :
City : TICKFAW
State : LA
Zip : 70466-1840
Country : US
Telephone Number : 985-662-2126
Fax Number :
Provider Business Practice Location Address
First Line : 49352 FEDELE RD
Second Line :
City : TICKFAW
State : LA
Zip : 70466-1840
Country : US
Telephone Number : 985-662-2126
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : JENNIFER LYNN HEWITT
Credential : OTD, OTR/L
Telephone Number : 985-662-2126
Provider Enumeration Date : 08/15/2006
Last Update Date : 01/04/2013

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