Healthcare Provider Details

I. General information

NPI: 1225950934
Provider Name (Legal Business Name): JENNA T COMPTON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3770 LAUREL RIDGE RD NW
ROANOKE VA
24017-1006
US

IV. Provider business mailing address

3770 LAUREL RIDGE RD NW
ROANOKE VA
24017-1006
US

V. Phone/Fax

Practice location:
  • Phone: 304-809-2757
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0119011056
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: