Healthcare Provider Details

I. General information

NPI: 1104122381
Provider Name (Legal Business Name): JENNIFER MARAGA OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2011
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 CHASEWOOD LN
DENTON TX
76205-8204
US

IV. Provider business mailing address

916 CHASEWOOD LN
DENTON TX
76205-8204
US

V. Phone/Fax

Practice location:
  • Phone: 940-315-4343
  • Fax:
Mailing address:
  • Phone: 940-315-4343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number116763
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number22236
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: