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General NPI Number Information
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NPI Number | 1285088856
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Entity Type | Individual
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Provider Name | JENNIFER ERIN GARTHE COTA/L
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Gender | Female
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Dates
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Enumeration Date | 04/19/2016
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 9035 BRYAN DAIRY RD
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City | SEMINOLE
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State | FL
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Zip | 33777-1104
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Country | US
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Telephone | 727-395-9619
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Fax |
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Provider Business Mailing Address
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Address Line | 117 25TH ST N LOWR
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City | SAINT PETERSBURG
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State | FL
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Zip | 33713-8745
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Country | US
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Telephone | 386-212-9747
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA 13141
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License Number State | FL
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