Healthcare Provider Details

I. General information

NPI: 1346885498
Provider Name (Legal Business Name): JENNY LI OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 HARRISON AVE
BOSTON MA
02118-2585
US

IV. Provider business mailing address

460 HARRISON AVE
BOSTON MA
02118-2585
US

V. Phone/Fax

Practice location:
  • Phone: 617-221-9057
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number423803
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: