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General NPI Number Information
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NPI Number | 1073209284
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Entity Type | Individual
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Provider Name | JENNA MARIE GREENE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/12/2023
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 24 BETHEA DR
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-4702
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Country | US
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Telephone | 843-682-7301
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Fax |
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Provider Business Mailing Address
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Address Line | 549 CRANE CT
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City | BLUFFTON
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State | SC
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Zip | 29909-1048
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Country | US
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Telephone | 848-210-0845
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XG0600X
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Taxonomy Name | Gerontology Occupational Therapist
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License Number | 6765
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 6765
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6765
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License Number State | SC
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