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General NPI Number Information
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NPI Number | 1154797983
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Entity Type | Individual
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Provider Name | JENNA PAGEL MOT, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/16/2015
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Last Update Date | 11/17/2019
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Provider Practice Location Address
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Address Line | 1571 CHRISTMAS RUN BLVD
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City | WOOSTER
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State | OH
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Zip | 44691-1503
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Country | US
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Telephone | 330-827-5105
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Fax |
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Provider Business Mailing Address
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Address Line | 166 PAR VIEW DR
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City | PATASKALA
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State | OH
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Zip | 43062-8991
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Country | US
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Telephone |
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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 | 7955
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License Number State | OH
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