Healthcare Provider Details

I. General information

NPI: 1265558928
Provider Name (Legal Business Name): JENNIFER A PRATT OTRL, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LORD HAYFORD RD
BUZZARDS BAY MA
02532-2358
US

IV. Provider business mailing address

10 LORD HAYFORD RD
BUZZARDS BAY MA
02532-2358
US

V. Phone/Fax

Practice location:
  • Phone: 508-280-5744
  • Fax:
Mailing address:
  • Phone: 508-280-5744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number7883
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: