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General NPI Number Information
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NPI Number | 1356610034
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Entity Type | Individual
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Provider Name | JENNIFER ELLEN BYRNE OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/23/2011
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 19722 LACE RD
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City | CHUGIAK
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State | AK
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Zip | 99567
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Country | US
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Telephone | 860-857-1763
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Fax |
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Provider Business Mailing Address
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Address Line | 19722 LACE RD
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City | CHUGIAK
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State | AK
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Zip | 99567
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Country | US
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Telephone | 860-857-1763
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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 | 116135
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License Number State | TX
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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 | 19212
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 186975
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License Number State | AK
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