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NPI Code Detail

MEDICARE: JENNIFER INOCENCIO

MEDICARE: JENNIFER INOCENCIO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist06361MD

General Provider Information

NPI Number : 1093048910
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER INOCENCIO
Provider Business Mailing Address
First Line : 11630 GLEN ARM RD
Second Line :
City : GLEN ARM
State : MD
Zip : 21057-9403
Country : US
Telephone Number : 410-319-5035
Fax Number : 410-592-3178
Provider Business Practice Location Address
First Line : 11630 GLEN ARM RD
Second Line :
City : GLEN ARM
State : MD
Zip : 21057-9403
Country : US
Telephone Number : 410-319-5035
Fax Number : 410-592-3178
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2009
Last Update Date : 09/10/2009

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Directions to “ JENNIFER INOCENCIO ” Practice Location

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