=====================================================
General NPI Number Information
=====================================================
NPI Number | 1184580037
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JADYN VICTORIA ALLEN MOT, OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/05/2026
-----------------------------------------------------
Last Update Date | 01/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 RAIDER WAY
-----------------------------------------------------
City | SPENCER
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25276-9236
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-927-6400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 264
-----------------------------------------------------
City | MOUNT CARBON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25139-0264
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 2547
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------