Healthcare Provider Details

I. General information

NPI: 1972939965
Provider Name (Legal Business Name): JODI SUE TOREN OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. JODI SUE FANT

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 11/24/2021
Certification Date: 11/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 PINEY MOUNTAIN DR
ASHEVILLE NC
28805-1297
US

IV. Provider business mailing address

1331 S FEDERAL HWY UNIT 344
BOYNTON BEACH FL
33435-6068
US

V. Phone/Fax

Practice location:
  • Phone: 828-608-9572
  • Fax:
Mailing address:
  • Phone: 915-274-4175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number15330
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number11215
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: