Healthcare Provider Details

I. General information

NPI: 1861049454
Provider Name (Legal Business Name): JENNIFER L HELLMAN OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2019
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 S GEAR AVE
WEST BURLINGTON IA
52655-1679
US

IV. Provider business mailing address

1221 S GEAR AVE
WEST BURLINGTON IA
52655-1679
US

V. Phone/Fax

Practice location:
  • Phone: 319-768-4100
  • Fax:
Mailing address:
  • Phone: 319-768-4100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number01271
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: