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General NPI Number Information
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NPI Number | 1255057998
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Entity Type | Individual
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Provider Name | JENNY CATHERINE EMLET OT/L
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 20 BLACK POINT RD
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City | SCARBOROUGH
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State | ME
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Zip | 04074-6378
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Country | US
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Telephone | 207-885-9415
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Fax |
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Provider Business Mailing Address
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Address Line | 201 US ROUTE 1 # 151
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City | SCARBOROUGH
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State | ME
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Zip | 04074-9048
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Country | US
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Telephone | 616-822-2698
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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 | 224ZE0001X
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Taxonomy Name | Environmental Modification Occupational Therapy Assistant
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License Number | OT2308
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License Number State | ME
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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 | OT2308
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License Number State | ME
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