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General NPI Number Information
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NPI Number | 1477847481
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Entity Type | Individual
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Provider Name | JENNIFER DIANE NEWTON OTR
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Gender | Female
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 601 HOLY TRINITY DR
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City | COVINGTON
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State | LA
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Zip | 70433-6230
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Country | US
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Telephone | 985-605-5950
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Fax |
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Provider Business Mailing Address
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Address Line | 22343 9TH ST
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City | ABITA SPRINGS
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State | LA
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Zip | 70420-3762
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Country | US
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Telephone | 985-951-0969
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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 | 5031-26
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License Number State | WI
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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 | OTT.200685
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License Number State | LA
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