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General NPI Number Information
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NPI Number | 1417396755
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Entity Type | Individual
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Provider Name | JENNIFER LYNN PIMENTEL OTR
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Gender | Female
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 7700 ARLINGTON BLVD STE 5113
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City | FALLS CHURCH
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State | VA
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Zip | 22042-2929
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Country | US
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Telephone | 703-681-9025
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Fax |
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Provider Business Mailing Address
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Address Line | 414 LONDON ST APT 3
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City | PORTSMOUTH
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State | VA
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Zip | 23704-2546
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Country | US
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Telephone | 505-205-2990
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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 | 310320
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License Number State |
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