Healthcare Provider Details

I. General information

NPI: 1619163847
Provider Name (Legal Business Name): JENNIFER L SEXTON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 10/05/2022
Certification Date: 10/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 NEWTOWN PIKE BLDG 1
LEXINGTON KY
40511-1277
US

IV. Provider business mailing address

1351 NEWTOWN PIKE BLDG 1
LEXINGTON KY
40511-1277
US

V. Phone/Fax

Practice location:
  • Phone: 859-253-1686
  • Fax:
Mailing address:
  • Phone: 859-253-1686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberR3784
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: