Healthcare Provider Details

I. General information

NPI: 1033442561
Provider Name (Legal Business Name): JENNIFER ANNE SALVITTI MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2009
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5437 BARLBY DR
INDIANAPOLIS IN
46237-8325
US

IV. Provider business mailing address

5437 BARLBY DRIVE
INDIANAPOLIS IN
46237
US

V. Phone/Fax

Practice location:
  • Phone: 812-871-6206
  • Fax:
Mailing address:
  • Phone: 812-871-6206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number31004689A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: