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General NPI Number Information
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NPI Number | 1124841622
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Entity Type | Individual
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Provider Name | JENNIFER HEROLD OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 3 LAUREL LN
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City | PALM COAST
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State | FL
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Zip | 32137-2632
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Country | US
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Telephone | 440-479-4308
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Fax |
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Provider Business Mailing Address
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Address Line | 3 LAUREL LN
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City | PALM COAST
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State | FL
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Zip | 32137-2632
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Country | US
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Telephone | 440-479-4308
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 7593
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 006805
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License Number State | GA
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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 | 31006948A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5201010301
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 4354
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License Number State | SC
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Taxonomy #6
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 6315
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 60881087
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License Number State | WA
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Taxonomy #8
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 20139
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License Number State | FL
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