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General NPI Number Information
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NPI Number | 1306411178
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Entity Type | Individual
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Provider Name | JENNIFER DIANE NEU MOT
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Gender | Female
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Dates
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Enumeration Date | 05/25/2021
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 1011 PECAN GROVE RD E
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City | SHERMAN
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State | TX
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Zip | 75090-3114
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Country | US
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Telephone | 903-892-9100
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Fax | 502-580-0205
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Provider Business Mailing Address
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Address Line | PO BOX 356
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City | LINDSAY
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State | TX
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Zip | 76250-0356
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Country | US
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Telephone | 817-247-1521
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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 | 115976
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License Number State | TX
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