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General NPI Number Information
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NPI Number | 1225644321
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Entity Type | Individual
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Provider Name | JENNA ELIZABETH WAIZ OT
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Gender | Female
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Dates
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Enumeration Date | 09/23/2020
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 4501 LOUISE UNDERWOOD WAY
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City | LOUISVILLE
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State | KY
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Zip | 40216-3987
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Country | US
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Telephone | 502-368-2348
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 DEPAUW BLVD STE 3070
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-6135
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Country | US
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Telephone | 855-324-0885
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Fax | 317-520-8200
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-20-132359
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License Number State | IN
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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 | 298241
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License Number State | KY
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