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General NPI Number Information
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NPI Number | 1205916012
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Entity Type | Individual
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Provider Name | JENNIFER L BRASPENNING OTR
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Gender | Female
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 09/29/2022
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Provider Practice Location Address
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Address Line | 74 JOURNEY WAY
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City | VALPARAISO
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State | IN
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Zip | 46383-0078
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Country | US
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Telephone | 192-554-3782
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Fax |
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Provider Business Mailing Address
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Address Line | 88 E 600 S
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City | VALPARAISO
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State | IN
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Zip | 46383-9608
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Country | US
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Telephone | 219-308-0881
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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 | 31003276A
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License Number State | IN
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