Healthcare Provider Details

I. General information

NPI: 1891966354
Provider Name (Legal Business Name): JENNIFER L MESSIER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2008
Last Update Date: 02/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 NE 10TH AVE
CRYSTAL RIVER FL
34429-4456
US

IV. Provider business mailing address

335 NE 10TH AVE
CRYSTAL RIVER FL
34429-4456
US

V. Phone/Fax

Practice location:
  • Phone: 352-795-5552
  • Fax: 352-795-7751
Mailing address:
  • Phone: 352-795-5552
  • Fax: 352-795-7751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT 13020
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: