Healthcare Provider Details

I. General information

NPI: 1952214637
Provider Name (Legal Business Name): JENNIFER CARNEVALE OTL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9525 E HIGHLAND RD
HOWELL MI
48843-9098
US

IV. Provider business mailing address

8071 BOULDER RIDGE CT
BRIGHTON MI
48116-6275
US

V. Phone/Fax

Practice location:
  • Phone: 810-626-2102
  • Fax:
Mailing address:
  • Phone: 954-856-6141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: