Healthcare Provider Details

I. General information

NPI: 1033946934
Provider Name (Legal Business Name): JENNA MOLNAR OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2024
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 SEA LARK LN
NAVARRE FL
32566-7406
US

IV. Provider business mailing address

3535 GULF BREEZE PKWY APT 5208
GULF BREEZE FL
32563-3622
US

V. Phone/Fax

Practice location:
  • Phone: 850-204-8030
  • Fax:
Mailing address:
  • Phone: 240-457-1467
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT25618
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: